Bakgrund: Ett missfall är inte bara en fysisk förlust, utan en känslomässig sådan. Känslan av förlusten för kvinnan förändras inte oavsett om graviditeten upphört i vecka fem eller 40 utan smärtan över att ha förlorat något kvarstår, detta kan innebära djup sorg med psykiska följder som depression. Därför är kvinnan som genomgått ett missfall oftast i stort behov av omvårdnad. Sjuksköterskors ansvar är att utföra en personcentrerad och säker vård, vilket är av stor vikt i mötet med kvinnan som genomgått missfall. Syfte: Syftet med litteraturstudien var att beskriva sjuksköterskors erfarenheter av att vårda kvinnor som genomgått missfall. Metod: En litteraturstudie med kvalitativ ansats genomfördes och baserades på 11 vetenskapliga, kvalitativa artiklar. Strukturerade databassökningar gjordes i tre olika databaser, PubMED, CINAHL samt PsycINFO. Artiklarna kvalitetsgranskades, analyserades med hjälp av innehållsanalys och sammanställdes i resultatet. Resultat: Analysen av artiklarna resulterade i tre kategorier: ”Känslomässiga reaktioner”, ”Professionell attityd” samt ”Kunskapsbrist. Resultatet visade att sjuksköterskors erfarenheter av att vårda kvinnor med missfall är en känslomässig upplevelse. Sjuksköterskor försöker att balansera mellan att vara professionell utan att vara för känslokall, och att vara emotionell utan vara för emotionellt engagerad i missfallet. Det framkom att det fanns kunskapsbrister hos sjuksköterskorna men även organisatoriska brister som försvårade omvårdnadsarbetet. Konklusion: Sammanfattningsvis tyder resultatet av denna litteraturstudie på att det krävs en förbättring av faktorerna kring omvårdnaden av kvinnor som genomgått missfall för att sjuksköterskor ska kunna ge en god och personcentrerad omvårdnad. Nyckelord: Erfarenheter, Kvinnor, Missfall, Omvårdnad, Sjuksköterskor / Background: A miscarriage is not just a physical loss, but an emotional one. The feeling of loss for the woman does not change regardless of whether the pregnancy has ceased in week five or 40, but the pain of having lost something remains, and this can involve deep grief with psychological consequences such as depression. Hence, the woman who has undergone a miscarriage is often in great need of nursing. Nurses' responsibility is to carry out a person-centered and safe care, which is of great importance in the meeting with the woman who has had a miscarriage. Aim: The purpose of the literature study was to describe the nurses' experiences of caring for women going through miscarriage. Method: A literature study with qualitative approach was conducted and based on 11 scientific, qualitative articles. Structured database searches were made in three different databases, PubMED, CINAHL and PsycINFO. The articles were qualityreviewed, analyzed using content analysis and compiled in the result. Results: The analysis of the articles resulted in three categories: "Emotional reactions", "Professional attitude" and "Lack of knowledge”. The result showed that nurses' experiences of caring for women with miscarriages are an emotional experience. Nurses try to balance between being professional without being insensitive, and being emotional, but not being too emotionally involved in the miscarriage. It emerged that there was a lack of knowledge among the nurses, but also organizational deficiencies that made the nursing work more difficult. Conclusion: In summary, the result of this literature study suggests that an improvement of the factors surrounding the care of women who have undergone a miscarriage is required for nurses to be able to provide a good and personcentered care. Keywords: Experiences, Miscarriage, Nurses, Nursing, Women

This literature review explored health care system experiences of women who miscarried. Particular attention was placed on the women's psychological well-being including coping and, grief needs along with cultural concerns. The findings indicated a need for future qualitative research to be conducted in order to examine the lived experience of women who miscarry. With new advanced home diagnostic technologies allowing women to confirm pregnancy before their first missed menstrual period, future research must place focus on early pregnancy loss occurring before the 12th week of gestation. With pregnancies capable of being identified prior to establishment of formal prenatal care, there is a need to provide better support and counseling services in the ambulatory setting. Additionally, in an effort to optimize pregnancy outcomes, perinatal care guidelines must include preconception counseling for all women of childbearing age. Lastly, the phenomenon of miscarriage requires further examination from the male partner's perspective in order to improve overall nursing care within an event that affects a family.

Pregnancy loss, the demise of a pregnancy at any time between implantation and delivery, is a common event in women’s lives, affecting approximately one in three pregnancies. Pregnancy loss often causes profound psychological distress to women, their partners, and their families. However, despite its frequency and troubling nature, relatively little is known about the natural history of pregnancy loss, especially the multitude of signs and symptoms that precede a loss and distinguish it from an ongoing healthy pregnancy. One of the challenges in describing the natural history of pregnancy loss is that most losses occur very early, before entry to clinical care, necessitating the use of preconception cohort studies. Few such studies have ever been conducted worldwide. This dissertation aimed to describe the natural history of early pregnancy loss at <20 weeks gestation for the first time using a unique preconception cohort with daily prospective follow-up from the start of the pregnancy attempt through seven weeks post-conception. To accomplish this goal, three specific aims were undertaken. First, a systematic literature review was conducted to synthesize the existing literature on the relationships between the signs and symptoms and pregnancy loss. Two analytic aims were then undertaken to delineate thoroughly the relationships between prospectively ascertained signs and symptoms—namely, vaginal bleeding, lower abdominal cramping, nausea and vomiting (hereafter referred to as “signs and symptoms”)—and subsequent early pregnancy loss. The first analytic aim used a fixed covariate and fixed effect survival analytic approach to estimate the cumulative incidence of early pregnancy loss by the presence of individual, combinations, and patterns of signs and symptoms and the associations between signs and symptoms and the cumulative incidence of pregnancy loss. The second analytic aim used a time-varying covariate and time-varying effect survival analytic approach to estimate the weekly associations between signs and symptoms and pregnancy loss to determine if these relationships were consistent or divergent across gestational ages. The results of the first and second analytic aims were then compared to gain a more complete understanding of the natural history of early pregnancy loss. The literature review revealed a dearth of studies on the signs and symptoms of pregnancy loss. Two preconception and 16 pregnancy cohort studies were identified. The literature suggested that vaginal bleeding, particularly heavy vaginal bleeding, was associated with an increased risk of pregnancy loss while vomiting, and in some studies nausea, was associated with a decreased risk of pregnancy loss. However, reliance on care-seeking cohorts, maternal retrospective reports of signs and symptoms after pregnancy loss, and retrospective recall of signs and symptoms over long periods (e.g., entire trimesters) may have biased the observed associations between signs and symptoms and pregnancy loss leading to incorrect inferences regarding the relationships between signs and symptoms and pregnancy loss. The two analytic aims addressed the data gaps identified in the literature review. The preconception cohort design with prospective daily follow-up from the beginning of the pregnancy attempt facilitated the ascertainment of pregnancies at the earliest stages of gestation and losses prior to clinical care entry through the use of urine-based home pregnancy testing. The daily reporting of multiple signs and symptoms in the first five weeks after a positive home pregnancy test, or approximately two to seven weeks post-conception, allowed for a full description of the relationships between signs and symptoms of pregnancy loss without recall bias. Data for the two analytic aims come from the Longitudinal Investigation of Fertility and the Environment (LIFE) Study, a population-based cohort with preconception recruitment of couples in 16 counties in Michigan and Texas followed for 12 months of trying for pregnancy and then through pregnancy loss or delivery for couples achieving an hCG pregnancy. 501 couples entered the study, and 347 achieved a pregnancy during the study period. Three hundred forty-one singleton pregnancies comprise the study population for the two analytic aims in this dissertation. Overall, 95 (28%) pregnancies in the study population ended in a pregnancy loss. Lower abdominal cramping, nausea, and vomiting were often reported during the early pregnancy period; vaginal bleeding was less common. The results of the fixed covariate fixed effect survival analysis from the first analytic aim demonstrated that vaginal bleeding, particularly heavy bleeding and bleeding accompanied by lower abdominal cramping, was associated with an increased risk of pregnancy loss. In contrast, the presence of vomiting, but not nausea alone, during the early pregnancy period was associated with a lower risk of loss. Analyses in the second analytic aim using weekly time-varying covariates and time-varying effects of signs and symptoms on pregnancy loss revealed some new findings. The first week after a positive pregnancy test appeared to be a vulnerable period. Vaginal bleeding and lower abdominal cramping were associated with an increased risk of loss in the first week but not in later weeks; conversely, nausea and/or vomiting were associated with lower risk of pregnancy loss but only after the first week. The observed weekly variations in the signs and symptoms of pregnancy loss may reflect changes in maternal adaptation to pregnancy across gestation. Overall, relatively little is known about the biological processes underlying healthy and unhealthy adaption to pregnancy as well as how embryo quality may affect these adaptive processes. More work is required from basic scientists, clinicians and epidemiologists to better understand the causes of signs and symptoms and their relationships to pregnancy loss, including genetic and environmental factors and their interactions. In the meantime, prognostic models developed from data in this dissertation using time-varying signs and symptoms may be useful to women and their health care providers for identifying pregnancies at increased risk for pregnancy loss. These models could prompt women to seek medical care when concerning patterns of signs and symptoms arise.

Tidiga missfall är vanligt förekommande och det kan ha stor psykisk påverkan på kvinnan. Hon kan känna sig deprimerad och uppleva sorg en längre tid efter missfallet. Studier har visat att kvinnor behöver stöd och samtal för att lättare kunna hantera sorgen. Barnmorskan arbetar utefter en personcentrerad vård där kvinnans fysiska och psykiska behov står i centrum. Barnmorskans roll är att finnas där för kvinnan och hjälpa henne i sorgeprocessen. Kvinnor kan ha olika tankar om vad som är bäst för henne vid missfallet och behovet av stöd kan se olika ut. Vården vid missfall bedrivs på olika sätt i olika delar av Sverige. Syftet med studien är att belysa kvinnors upplevelse av stöd från vårdpersonal i samband med tidigt missfall. Metoden som använts är en kvalitativ innehållsanalys med en induktiv ansats. Sju kvinnor från olika delar av Sverige har intervjuats. Studien resulterade i fem kategorier: Övergivenhet, Bekräftelse, Ovisshet, Trygghet och Maktlöshet med temat; En variation av känslor som påverkar helhetsupplevelsen. Det finns en tydligare plan i vården för de kvinnor som haft upprepade missfall än de som haft enstaka missfall. Det var en skillnad mellan dessa grupper när det gäller vilket stöd de fått. Trots att vårdpersonalen är medveten om missfallets påverkan på kvinnan så upplever kvinnorna att de inte fått det individanpassade stöd som de önskat. Barnmorskan bör i större utsträckning ha ansvaret för kvinnor som genomgår missfall då detta ligger inom deras profession, sexuell och reproduktiv hälsa. Alla kvinnor bör få en mer jämlik vård när vården är personcentrerad redan vid första missfallet. / Early miscarriages are common, and it can have a major psychological impact on a woman. She may feel depressed and experience grief for a long time after. Studies have shown that women need support and interlocution to more easily handle the grief. The midwife work according to a person-centered care where the woman's physical and psychological needs are central. The midwife role is to be there for the woman and help her in the grieving process. Women may have different ideas about what is best for her at her miscarriage and the need for support can take different forms. Care for miscarriage is conducted in different ways in different parts of Sweden. The purpose of the study is to highlight women's experiences of support from health professionals in connection with early miscarriage. The method used is qualitative content analysis using an inductive approach. Seven women from different parts of Sweden were interviewed. The study resulted in five categories: Abandonment, Confirmation, Uncertainty, Confidence and Powerlessness with the theme; A variety of feelings that affect the overall experience. There is a clearer plan of care for women with recurrent miscarriages than for those with a single miscarriage. There was a difference between these groups in terms of the support they received. Although the care staff is aware of the miscarriage impact on the woman, the experiences of the women were that they did not receive the individualized support they required. The midwife should to a greater extent be responsible for women undergoing miscarriage when this is within  their profession, sexual and reproductive health. All women should get a more equitable care if the care is person-centered at the first miscarriage.

Many women experience miscarriage every year. Every fourth woman who has given birth reports that she has previous experience of miscarriage. In a study of all women in the Swedish Medical Birth Register 1983-2003, we found that the number of cases of self reported miscarriage had increased in Sweden during this 21 year period. This increase can be explained by the introduction of sensitive pregnancy tests around 1990, as well as an increase in the mean age of the mothers, by approximately 3 years, during the observation period. The risk of miscarriage is 13% with the first child. With subsequent pregnancies, the risk of miscarriage is 8%, 6% and 4% with the second, third and fourth child, respectively. Thirteen of these women who had suffered a recent miscarriage were interviewed four months later, and their feelings of guilt and emptiness were explored. Their experience was that they wanted their questions to be answered, and that they wanted others to treat them as the mothers to be that they felt themselves to be. They also experienced the need for time to grieve their loss. Measurement of grief by means of the Perinatal Grief Scale (PGS) is used in research but has also been proposed for clinical use. We have translated this psychological instrument to Swedish, back-translated and tested it in a small pilot study. In a randomized controlled study, women with early miscarriage were allocated, either to a structured visit (study group) or a regular visit (control group) to a midwife. The structured visit was conducted according to the Swanson caring theory. We could conclude that the structured visit had no significant effect on grief compared to the regular visit, as measured using the PGS. However, women with the sub-diagnosis missed abortion have significantly more grief four months after early miscarriage, regardless of visit type. We also performed a content analysis of the tape-recorded structured follow-up visit. The code-key used was Bonanno and Kaltman’s general grief categorization. Women’s expression of grief after miscarriage was found to be very similar to the grief experienced following the death of a relative. Furthermore, the grief was found to be independent of number of children, women’s age, or earlier experience of miscarriage. Conclusions: Every fourth woman who gives birth reports that she has also experienced early miscarriage. The experience of these women is that they have suffered a substantial loss and their reaction is grief similar to that experienced following the death of a relative.

Background: Miscarriage is a common phenomenon in our society. It is reported that approximately 17 % of all pregnant women in Sweden go through a miscarriage every year. For many women miscarriage is a tumultuous life event that often has a deep emotional impact. Miscarriage is a subject that often is prohibited to talk about in our western society. Consequently this means that nurses have an important role in the emotional support for these women. This can be a challenge in Sweden since the hospital stay for women who go through a miscarriage is very short and often limited to a day.Aim: This study aims to highlight women's reported experiences of miscarriage and their requested support.Methods: This study is based on twelve original scientific articles, of which ten had a qualitative approach, one had a quantitative approach and one had a mixed approach.Results: The study showed that the experience of miscarriage is individual. How women experience their miscarriage is largely linked to a woman's thoughts about her pregnancy. A miscarriage can evoke complex reactions if the woman starts to fantasize about her child and starts to identify herself as a mother. Many of the women complained about the lack of care that was given to them from the health care, which had a significant role in how they experienced the miscarriage. They requested more acknowledgements and more humanistic treatment and care, as well as follow-ups. The study also showed that women feel that relatives are a support factor to them during the miscarriage.Discussions: The results showed that there are flaws in the care of women who has experienced miscarriage, particularly that the women’s emotional needs are not met. Nurses who work in a gynecological unit require enhanced skills and preparedness in the health care of women undergoing miscarriage. / Bakgrund: Missfall är ett vanligt förekommande fenomen i vårt samhälle. I Sverige rapporteras varje år att cirka 17 % av alla gravida kvinnor genomgår missfall. För många kvinnor är missfall en omtumlande händelse i livet som ofta har en djup emotionell påverkan. Missfall är till stor del ett ämne som är tabubelagt att samtala om i vårt västerländska samhälle. Därför har sjuksköterskor en viktig roll i det emotionella stödet till dessa kvinnor, vilket innebär en utmaning i Sverige eftersom vårdtiden för kvinnor som genomgått ett missfall är mycket kort, ofta begränsad till ett dygn.Syfte: Denna litteraturstudie syftar till att belysa kvinnors rapporterade upplevelser av missfall samt vilka stödinsatser de efterfrågar.Metod: Litteraturstudien är baserad på tolv vetenskapliga originalartiklar varav tio stycken hade kvalitativ ansats, en hade kvantitativ och en hade mixad ansats.Resultat: I studien framkom det att upplevelsen av missfall är individuell. Hur kvinnor upplever sitt missfall är till stor del sammankopplat med kvinnans tankar runt sin graviditet. Om kvinnan har börjat fantisera om sitt barn och börjat identifiera sig med en ny identitet som mor, kan ett missfall framkalla komplexa känslomässiga reaktioner. Många av kvinnorna påtalade brister i bemötandet från sjukvården, vilket hade en betydande roll för hur de upplevde missfallet. De efterfrågade mer bekräftelse och ett mer humanistiskt bemötande och vårdande, samt uppföljningar. Studien visade även att kvinnor upplever att de närstående är viktiga stödfaktorer för dem under missfallet.Diskussion: Resultatet visade att det föreligger brister inom vård av kvinnor som genomgått missfall, framförallt genom att kvinnornas emotionella behov inte blir tillgodosedda. Sjuksköterskor som arbetar inom gynekologiska enheten behöver en ökad kompetens och beredskap i vårdandet av kvinnor som genomgår missfall.

Bakgrund: Av alla graviditeter slutar 10-20% med ett missfall, vilket betyder att det är vanligt förekommande och drabbar många kvinnor. Ett missfall kan innebära en väldigt traumatisk upplevelse för den drabbade och är både psykiskt och fysiskt påfrestande.   Syfte: Syftet med litteraturstudien är att beskriva kvinnors upplevelser av missfall.   Metod: Litteraturstudie där resultatet baseras på 10 vetenskapliga artiklar baserade på en kvalitativ ansats.   Resultat: Vid ett missfall upplevde kvinnorna i studierna ofta att vårdpersonal gav för lite information och hade bristande förståelse. Mer psykosocialt stöd var en återkommande önskan, då de sällan blev erbjudna det. Missfallet innebar mer än att förlora ett framtida barn. Det var en komplex situation, där kvinnan drabbades av både fysisk och psykisk smärta. Känslor såsom att förlora kontrollen, att skuldbelägga sig själv, oro och rädsla inför framtiden var ofta förekommande. Sorgen över vad de kunde haft var något som kunde vara i flera år efter missfallet. Att få bearbeta sorgen visade sig vara en väldigt viktig del för de flesta kvinnorna.   Slutsats: Sorg är något som de flesta kvinnor upplever efter ett missfall och många av dem efterfrågar mer stöd och hjälp i hanteringen av sorgearbetet. Att drabbas av psykisk ohälsa, såsom depression och ångest är vanligt förekommande efter ett missfall. Genom att erbjuda alla drabbade kvinnor psykosocialt stöd i anslutning till missfallet kan psykisk ohälsa och onödigt lidande förebyggas. Det finns ett behov av ett bättre bemötande samt mer information från vårdpersonal. Eftersom brist på information kan leda till att kvinnan skuldbelägger sig själv bör detta prioriteras. Sjukvårdspersonal behöver mer kunskap gällande upplevelser av missfall för att kunna ge en tillfredsställande omvårdnad där kvinnan känner sig trygg och väl bemött. Det bör dock tas hänsyn till att allas upplevelser av ett missfall är individuellt och vården bör därför anpassas därefter. / Background: Of all pregnancies, 10-20% end with miscarriage, which means that it is a common matter and affects many. It can be a very traumatic experience and the effects it has on women can be both mental and physical.   Purpose: The purpose of this literary study is to describe women's experiences of miscarriage.   Method: The method of the research is a literary study, which is based on 10 original articles, with a qualitative approach.   Results: When a miscarriage occurred, women often felt that the care staff offered limited information and had a lack of understanding. More psychosocial support was a recurring desire as the women seldom felt that they were provided with it. The miscarriage meant more to them than losing a future child. It was a complex situation where the woman was in both physical and mental pain. Emotions such as lack of control, self-blame, anxiety, fearing for the future and sorrow were frequent. Grieving over what they could have had was something that could be experienced over several years after the miscarriage. Processing the grief was a very important part for most women.    Conclusion: Grief is something that most women experience after a miscarriage and many of them are asking for more support and help in dealing with grief. To suffer from mental illness, such as depression and anxiety are common after a miscarriage. By offering all affected women psychosocial support after the miscarriage, mental illness and unnecessary suffering can be prevented. There is a need for a better refutation as well as more information from health professionals. Because of the lack of information woman sometimes blames themselves, therefore this should be a priority. Healthcare professionals need more knowledge regarding experiences of miscarriage in order to provide adequate care where the woman can feel safe and be treated well. However, it should be taken into account that everyone's experience of a miscarriage are individually and care should therefore be adjusted accordingly.

A research report submitted to the Faculties of Health Sciences and Humanities, Schools of Public Health and Social Sciences, University of Witwatersrand, Johannesburg in partial fulfilment of the requirements for the degree of Master of Arts in the field of Demography and Population Studies, October 2017 / Background: Various international and national commitments and interventions that focus on improving maternal, newborn and child health have been established in South Africa. Irrespective of these efforts, adverse pregnancy outcomes (stillbirths and miscarriages) remain invisible within policies and programmes intended to reduce this public health burden thus leading to its high rate in South Africa. This mismatch of burden to action is due to several factors that keep stillbirths and miscarriages hidden, notably underreporting which leads to a lack of data and a lack of consensus on priority interventions and, social taboos that reduce the visibility of stillbirths and the associated family morning. While studies have identified a number of individual demographic and socioeconomic factors associated with stillbirths and miscarriages, the role of household socioeconomic factors remain unexplored. Poor socioeconomic conditions within a household have broadly been linked with poor health and negative birth outcome among pregnant women. This study therefore sought to identify demographic and household socioeconomic associated with stillbirths and miscarriages in South Africa. Methods: This study utilized secondary data from the 2010 – 2014 South African General Household Survey (SAGHS). The study sample comprises of women of reproductive age 15 49 years who were resident in the households selected to participate in the SAGHS. A sample of 248,057 women were included in the study; these are women who reported to have been pregnant in the last 12 months preceding the survey from 2010-2014. The population of interest in this study are South African women whose pregnancy has ended in a stillbirth and or a miscarriage. The outcome variable was pregnancy outcomes (stillbirths, miscarriages and others) while predictor variables include household wealth status, maternal age, source of drinking water, type of toilet facility, sex of household head, province of residence, household electricity, population group and HIV status. Data analysis was done in three stages. First, univariate analysis was done to provide descriptive results of the study population. The second staged involved a bivariate analysis producing odds ratios to examine the association between each predictor variable with each pregnancy outcome. The third stage included an unadjusted (bivariate) and adjusted (multivariate) multinomial logistic regression producing relative risk ratios (RRRs) to examine the demographic and household socioeconomic determinants of stillbirths and miscarriages. Results: The levels of stillbirths were 0.17% and 0.37% in 2013 compared to 0.11% and 0.12% respectively. The stillbirth rate (SBR) from 2010-2014 was 25.7 per 1000 births while miscarriage rate was 24.5 per 1000 pregnancies. Results from the multinomial logistic regression showed that maternal age, race, sex of household head, province of residence, source of drinking water, type of toilet facility, geographic type, household wealth index, hypertension and HIV positive status are significant determinants of stillbirths and miscarriages among women in South Africa. Advanced maternal age (34-39 and 40-44 years), rural residence, being Black, use of other type of toilet facilities, poor wealth quintile, Northern Cape province, being 000HIV positive and drinking piped water are associated with an increased risk of stillbirths and miscarriages. Conclusion: This study found that demographic and household socioeconomic factors are associated with pregnancy outcomes (stillbirths and miscarriages) among women aged 15-49 years in South Africa. This study has demonstrated the fact that household socioeconomic factors are important in understanding the determinants of stillbirths and miscarriages. Thus, the outcomes of pregnancy are not separable from the socioeconomic conditions of the pregnant women within a household as maternal poverty can translate to poor foetal health. Interventions on maternal, newborn and child health should also be more targeted at these pregnancy outcomes as stand-alone health indicators to address the dearth of data and to ensure proper monitoring. Furthermore, women in remote areas who do not have access to electricity, toilet facilities and other important assets in their household should be prioritized by programs on poverty alleviation. Lastly, it is crucial that quality obstetric care services should be made available, accessible and affordable for women in remote areas. This may improve the outcomes of pregnancy through early detection of pregnancy complications. / XL2018

Leung, Siu Lun. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2013. / Includes bibliographical references (leaves 153-190). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts also in Chinese.

Objetivos: O objetivo do nosso estudo foi verificar se a umidificação dos comprimidos com formulação brasileira de misoprostol vaginal aumenta a dilatação cervical antes da aspiração manual por vácuo (AMIU), em comparação com o uso de misoprostol seco nos abortos espontâneos no primeiro trimestre. O objetivo secundário foi verificar se houve correlação entre o pH vaginal e o grau de dilatação cervical usando um comprimido de misoprostol umedecido ou seco. Métodos: Estudo unicêntrico, duplo cego e randomizado, com 46 pacientes com aborto espontâneo de primeiro trimestre foram alocados aleatoriamente para o tratamento com 400 μg de misoprostol seco ou umedecido (com 200 μl de água destilada). Resultados: A dilatação cervical mediana (intervalo) nos grupos úmido e seco foi de 8 mm (6-12 mm) e 7 mm (5-10 mm), respectivamente ( p = 0,06). O tempo médio entre a inserção de misoprostol e a realização do procedimento não diferiu entre os grupos seco (406 min, intervalo 180-550 min) e molhado (448 min, intervalo 180-526 min) ( p = 0,1). Não foi encontrada correlação entre o pH vaginal e a dilatação cervical usando dados continuos ( p = 0.57; r = 0.08; intervalo de confiança de 95% -0.02, 0.3) ou dados dicotômicos (pH ≤5 /> 5, dilatação cervical ≥8 mm ou <8 mm; p = 0,8). Conclusão: Não foi observada diferença na dilatação cervical entre o uso de misoprostol umedecido e não umedecido antes do AMIU. / Objectives: The aim of our study was to ascertain whether moistening the Brazilian formulation of vaginal misoprostol tablets increases cervical dilation before manual vacuum aspiration (MVA), compared with use of dry misoprostol, in first-trimester miscarriage. The secondary objective was to ascertain whether there was any correlation between vaginal pH and the degree of cervical dilation using a moistened or dry misoprostol tablet. Methods: In a single-centre, double-blind, randomised trial, 46 patients with first-trimester miscarriage were randomly allocated to treatment with dry or moistened (with 200 μl distilled water) 400μg of misoprostol. Results: The median (range) cervical dilation in the wet and dry groups was 8 mm (6–12 mm) and 7 mm (5–10 mm), respectively (p=0.06). The median time between misoprostol insertion and carrying out the procedure did not differ between the dry (406 min, range 180–550 min) and wet (448 min, range 180–526 min) groups (p=0.1). No correlation was found between vaginal pH and cervical dilation using continuous data (p=0.57; r=0.08; 95% confidence interval -0.02, 0.3) or dichotomous data (pH ≤5/>5; cervical dilation ≥8 mm or <8 mm; p=0.8). Conclusion: No difference was observed in cervical dilation between moistened and non-moistened misoprostol use prior to MVA.