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.

Bakgrund: Av alla diagnostiserade graviditeter avslutas tio till femton procent spontant i missfall. Kvinnans reaktion vid missfall kan till stor del bero på om kvinnan blivit planerat gravid eller var ovetandes om graviditeten. Sjuksköterskor har en betydande roll för att tillhandahålla god omvårdnad till kvinnor som genomgått missfall, vilket innebär en utmaning med begränsade resurser. Syfte: Litteraturöversiktens syfte var att beskriva kvinnors upplevelser av att genomgå missfall. Metod: En litteraturöversikt baserad på 16 vetenskapliga artiklar med kvalitativ och kvantitativ ansats, som samlades in från databaserna CINAHL, PubMed, PsycINFO och Web of Science. Artiklarna har kvalitetsgranskats, systematiskt analyserats och sammanställts i resultatet. Resultat: Analysen resulterade i följande fem huvudkategorier; från förväntansfull graviditet till traumatiskt missfall, behov av omvårdnad, psykisk och emotionell påverkan, behov av stöd från hälso- och sjukvården och anhöriga samt kvarstående psykisk påverkan efter missfall. Slutsats: Varje kvinna har en unik upplevelse av att genomgå missfall. Den individuella upplevelsen baseras på diverse faktorer och kan i sin tur generera i emotionella reaktioner. Trots en tillfredsställelse av den kroppsliga vården vid missfall finns avsaknad av vård, stöd och uppföljning för konfrontering av de emotionella reaktionerna samt det psykiska måendet. För att ge kvinnor en personcentrerad, säker vård krävs att vidare forskning utförs där kvinnors specifika behov identifieras. / Background: Among ten to fifteen percent of all diagnosed pregnancies ends in a spontaneous miscarriage. Women’s reaction in case of miscarriage can due to the fact that the pregnancy was planned or if the woman was unaware of the pregnancy. Nurses have a significant role to play in providning good care for women who have undergone miscarriage, which means a challenge with limited resources. Purpose: The purpose of the literature review was to describe women’s experience of going through a miscarriage. Methods: A literature review based on 16 scientific articles with qualitative and quantitative approach, collected through the databases CINAHL, PubMed, PsycINFO and Web of Science. The articles have been quality examined, systematically analyzed and compiled in the result. Results: The analysis resulted in five main categories; from expectant pregnancy to traumatic miscarriage, need for nursing, mental and emotional impact, the need for support from the health care system and relatives as well as residual mental effects after miscarriage. Conclusion: Every woman has a unique experience of going through miscarriage. The individual experience is based on various factors and can in turn generate in emotional reactions. Despite the satisfaction of the physical treatment of miscarriage, there is an absence of care, support and follow-up for the confrontation of the emotional reactions and the mental health. To give women a person-centered, safe health care requires that further research is carried out in which women’s specific needs are identified.

O aborto espontâneo recorrente (AER) é definido pela ocorrência de três ou mais abortos espontâneos consecutivos com idade gestacional de até 20 semanas. O AER é um evento multifatorial, tem um índice de elucidação da causa na ordem de 50% e, mesmo com os avanços da medicina diagnóstica ainda assim 40% dos casos permanecem com sua causa desconhecida. O crescimento fetal é totalmente dependente do aporte de nutrientes oirundos da mãe, dentre esses nutrientes a cobalamina e o ácido fólico desempenham um papel fundamental para a viabilidade fetal. O objetivo geral deste estudo foi investigar se existe associação entre polimorfismos em genes relacionados ao metabolismo da cobalamina (MTHFR c.677C>T, TCN2 c. 776C>G e TCN2 c. 67A>G), e o aborto espontâneo recorrente. Os objetivos específicos deste estudo foram: 1 determinar se os polimorfismos MTHFR c. 677C>T, TCN2 c. 776C>G e TCN2 c. 67A>G estão associados ao aborto primário e secundário. 2 - Avaliar se os genótipos dos polimorfismos estudados estão relacionados com as concentrações séricas de cobalamina, folato e homocisteína total em mulheres com aborto espontâneo recorrente. Foram incluídas 256 mulheres com história de abortos espontâneos recorrentes, provenientes do Ambulatório de Obstetrícia da Clínica Obstétrica do Hospital das Clínicas da Faculdade de Medicina da USP e 264 mulheres saudáveis, sem história de aborto espontâneo e que tenham tido pelo menos duas gestações normais (grupo controle), pareadas segundo as idades. Foram colhidas amostras de sangue para a realização das dosagens bioquímicas, hormonais e das vitaminas e também para a realização das genotipagens dos polimorfismos por meio de PCR-RPFL (MTHFR c.677C>T , TCN c.776C>G e c. 67A>G). As dosagens bioquímicas e hormonais apresentaram resultados dentro dos limites de variação do normal. Quanto as concentrações de folato e cobalamina, houve diferença estatística significante entre os grupos p<0,05. As frequências dos genótipos e alelos para os polimorfismos estudados comparadas entre os grupos abortos primário, aborto secundário e grupo controle não apresentaram diferença estatística significante. Optamos a seguir por dividir o grupo de estudo entre abortos primários, onde não existe história de feto viável, e secundário neste caso onde há história de feto viável. Desta forma foram refeitas as análises estatísticas entre os grupos e encontramos diferença estatísticamente significante p<0,05 quando confrontamos os genótipos do polimorfismo TCN c.776C>G entre o grupo primário e o grupo controle. Em conclusão, quando comparamos as frequência dos genótipos e alelos em conjunto não apresentaram associação com o AER. Quando comparado separadamente o grupo de aborto primário e grupo controle houve diferença estatística significante associando o polimorfismo TCN2 c.776C>G ao AER primário. / The recurrent spontaneous abortion (RSA) is defined by the occurrence of three or more consecutive miscarriages with gestational age up to 20 weeks. The AER is a multifactorial event, has an index of elucidating the cause of around 50% and, even with advances in diagnostic medicine still remain 40% of cases with a known cause. Fetal growth is totally dependent on the supply of nutrients from the mother oirundos among these nutrients cobalamin and folic acid play a key role in fetal viability. The aim of this study was to investigate whether there is an association between polymorphisms in genes related to metabolism of cobalamin (MTHFR c.677C> T, c TCN2. 776c> G and c TCN2. 67A> G), and recurrent miscarriage. The specific objectives of this study were: 1 determine whether MTHFR c. 677C> T, TCN2 c. 776c> G and c TCN2. 67A> G are associated with abortion primary and secondary. 2 - Assess whether the genotypes studied polymorphisms are associated with serum concentrations of cobalamin, folate and total homocysteine in women with recurrent spontaneous abortion. We included 256 women with a history of recurrent miscarriages, from the Clinic of Gynecology, Obstetrics, Hospital das Clinicas, Faculty of Medicine, USP and 264 healthy women with no history of miscarriage and have had at least two normal pregnancies (group control), matched according to age. Blood samples were collected to perform the biochemical, hormonal and vitamins and also to perform the genotyping of polymorphisms by PCR-RPFL (MTHFR c.677C> T, TCN c.776C> G and c. 67A> G). The biochemical and hormonal results presented within the limits of normal variation. As the concentrations of folate and cobalamin, statistically significant difference between groups p <0.05. The frequencies of genotypes and alleles for the polymorphisms studied compared between groups abortions primary, secondary and abortion control group showed no statistically significant difference. We chose then to divide the study group between primary abortions where there is a history of viable fetus, and secondary in this case where there is a history of viable fetus. Thus were repeated statistical analyzes between groups and found statistically significant difference p <0.05 when confronted TCN genotypes of polymorphism c.776C> G between the primary group and the control group. In conclusion, when comparing the frequency of genotypes and alleles together apresntaram no association with AER. When compared separately the group of abortion primary and control group was statistically significant associated polymorphism TCN2 c.776C> G the primary AER.

Bakgrund: Missfall drabbar var fjärde kvinna, men enligt tidigare forskning bemöter inte vårdpersonalen kvinnan med respekt för hennes situation, något som leder till en negativ vårdupplevelse och som kan leda till psykisk ohälsa. Syfte: Syftet med examensarbetet var att belysa kvinnors upplevelser av bemötande från vården och anhöriga i samband med missfall. Metod: Examensarbetet utgick ifrån en kvantitativ och kvalitativ empirisk forskningsmetod i form av en sammanställning av 83 enkätsvar och en innehållsanalys av 20 blogginlägg. Resultat: Majoriteten av kvinnorna har fått uppleva bristande stöd från både anhöriga och vården. Kvinnorna har inte blivit erbjudna den vård de ansett sig behöva, de blev även utsatta för dåligt bemötande från vårdpersonalen i form av okänsliga kommentarer. Okänsligheten var kopplat till att vården bemöter missfall som ett rutinfall och inte ser missfall utifrån kvinnans perspektiv. Slutsatser: Missfall orsakar sorg för de kvinnor som drabbas, därför behöver de bli bemötta på ett värdigt sätt och få stöd både från omgivningen och vården. Förslag på framtida forskning: Vidare forskning krävs för att fastställa hur sjuksköterskor kan förbättra upplevelsen för kvinnor, tillgodose deras behov och öka deras välbefinnande. Författarna anser även att vidare forskning krävs för att förstå hur kvinnors partner upplever missfall. / Background: Miscarriage affects one in four women. Despite the prevalence, research suggests that healthcare professionals do not treat affected women with respect for their personal situation. This leads to negative healthcare experiences for patients, which can in turn contribute to mental illness. Aim: The purpose of the thesis was to highlight women's experiences of support from healthcare and relatives in connection with miscarriage. Method: The thesis was based on a qualitative and quantitative empirical research method in the form of a summary of 83 survey responses and a content analysis of 20 blog posts. Result: The majority of women have experienced insufficient support from both relatives and healthcare. The women have not been offered the care they considered necessary, they were also exposed to poor treatment from the healthcare staff in the form of insensitive comments. The insensitivity of these professionals was linked to the treatment of miscarriage as routine and a failure to consider the individual woman’s perspective. Conclusion: Miscarriage causes severe grief for the women who suffer it. Therefore, they need to be treated in a dignified way and receive support from caregivers and others in their environment. Suggestions for future research: Further investigation is needed to determine how nurses can improve the experience for women, meet their needs, and increase their well-being. The authors recommend further research to understand how women's partners experience miscarriage.

Objectives This study aimed to assess the association between perceived social support and induced abortion among young women in Lima, Peru. In addition, prevalence and incidence of induced abortion was estimated. Methods/Principal findings A cross-sectional study enrolling women aged 18–25 years from maternal health centers in Southern Lima, Peru, was conducted. Induced abortion was defined as the difference between the total number of pregnancies ended in abortion and the number of spontaneous abortions; whereas perceived social support was assessed using the DUKE-UNC scale. Prevalence and incidence of induced abortion (per 100 person-years risk) was estimated, and the association of interest was evaluated using Poisson regression models with robust variance. A total of 298 women were enrolled, mean age 21.7 (± 2.2) years. Low levels of social support were found in 43.6% (95%CI 38.0%–49.3%), and 17.4% (95%CI: 13.1%–21.8%) women reported at least one induced abortion. The incidence of induced abortion was 2.37 (95%CI: 1.81–3.11) per 100 person-years risk. The multivariable model showed evidence of the association between low perceived social support and induced abortion (RR = 1.94; 95%CI: 1.14–3.30) after controlling for confounders. Conclusions There was evidence of an association between low perceived social support and induced abortion among women aged 18 to 25 years. Incidence of induced abortion was similar or even greater than rates of countries where abortion is legal. Strategies to increase social support and reduce induced abortion rates are needed.

At least 30 million men are infertile around the world, identifying male factor infertility as a global health issue. In the past 70 years, evidence of a significant general decline in sperm quality has been reported, prompting concerns about the implications for reproductive health. Over the same period, there have been substantial changes in human lifestyles. New technologies, such as mobile phones and wi-fi, have been proposed to have a negative impact on a range of health outcomes, from an increased risk of cancer to a decrease in fertility. However, these links remain controversial. Over the last 30 years, the introduction of assisted reproductive technologies (ART) has offered infertile patients, particularly men with severe male factor infertility, a successful treatment option. However, miscarriage rates associated with fertility treatment can be as high as 30% and how this risk had changed over time was unclear. In addition, there are natural fluctuations in human health, including seasonal changes to birth rates. However, the clinical implications of these fluctuations need to be established. In this thesis, using an integrated approach that combined epidemiological research with laboratory investigations, I show that sperm quality is negatively affected by exposure to RF-EMR from mobile phones and wi-fi. I also identified a seasonal summer increase in sperm motility and morphology that followed patterns of seasonality in birth rates and in the success of assisted conception cycles. I showed that although the number of successful conceptions from ART has increased over time, there has been an equal increase in miscarriage rates. Male reproductive health continues to be under-researched when compared with the female, this inequality needs to be addressed in order to understand the causes of the decline in male fertility and the relationship this has with subsequent reproductive success.

Abstract Each year approximately 11,000 induced abortions are performed in Finland, the majority of these women being younger than 25 years of age. Medical abortion with the antiprogestin mifepristone and the prostaglandin analogue misoprostol is increasingly being used instead of surgical method (dilatation of cervix and uterine evacuation with instruments). Similarly, miscarriages can be treated with medical or surgical management. Still, clinical outcomes of the medical treatment of miscarriage are not well established, and various different regimens exist. The aim of this study was to investigate the frequency and risk factors of repeat abortions and immediate post-abortal complications, focusing especially on the impact of the method of abortion. National health registries were used as a data source. Another part of the study was aimed at comparing the efficacy, acceptability and cost-effectiveness of the medical and surgical treatment of miscarriage. In national cohort, the risk of repeat abortion was associated with sociodemographic characteristics (parity, previous abortion, low socioeconomic status, being unmarried but cohabiting or single), but not with the method of abortion. The risk of repeat termination of pregnancy decreased with age, among women living in rural area, and when intrauterine devices or sterilization were planned for future contraception. The overall incidence of adverse events was 4-fold greater in the medical compared to the surgical abortion cohort. Hemorrhage and incomplete abortion were more common following medical abortion, but the incidence of infections did not differ. Medical and surgical treatment of miscarriage were compared in a randomized setting; the efficacy of the treatment did not differ. Medically treated patients were less satisfied with the treatment and had experienced more pain. In the cost analysis, the primary costs of the surgical treatment were higher, but more unexpected events and complications increased the secondary costs in the medical group. In summary, medical abortion offered a good alternative to surgical method without increasing the risk of repeat abortions, but with an increased risk of short-term adverse events. The medical method was efficient in treating miscarriages, and the majority of women were satisfied with the treatment. Neither of the methods was economically superior in treating miscarriage.

O aborto espontâneo recorrente (AER) caracteriza-se pela ocorrência de três ou mais abortos consecutivos espontâneos até a 20ª semana de gestação. É uma condição patológica multifatorial, em que alterações morfológicas uterinas, distúrbios endócrinos, alterações no cariótipo, polimorfismos genéticos relacionados aos genes envolvidos no metabolismo da homocisteína, hemostasia, infecções, autoanticorpos e o processo inflamatório podem contribuir para a ocorrência de AER. O estado fisiológico do endométrio é essencial para a implantação do embrião no útero durante a gestação. Na interface materno-fetal, há uma modulação de citocinas, necessária para o estabelecimento da angiogênese e desenvolvimento da placenta. Um desequilíbrio entre as citocinas pode diminuir a tolerância ao feto e ocasionar rejeição fetal. A concentração de citocinas pode ser modificada por conta de uma diminuição na expressão de alguns genes, e esta pode ser regulada pelo seu estado de metilação sítio-específica. A metilação do DNA é um mecanismo epigenético de regulação gênica, e que corresponde à incorporação de grupos metila em ilhas CpG localizadas próximas às regiões promotoras de genes humanos, e isso pode ser importante na avaliação do risco de complicações gestacionais. Além disso, o estado nutricional de vitaminas foi relacionado a alterações no padrão de metilação de alguns genes. Os objetivos deste trabalho foram avaliar as concentrações dos mediadores inflamatórios em mulheres com aborto e em grupo controle, verificar correlações entre as concentrações de vitaminas, homocisteína total e taxa de metilação do DNA, verificar correlações entre concentração de citocinas e taxa de metilação do DNA e determinar odds ratio (IC 95%) de ter aborto em modelos multivariados. Foram incluídas 253 mulheres com história de aborto recorrente e 264 mulheres saudáveis (controle). O DNA foi extraído de leucócitos de sangue periférico para o estudo de metilação. Foram separadas alíquotas de soro e plasma para dosagem de vitaminas, metabólitos e citocinas. Não foram encontradas diferenças nas taxas de metilação do DNA entre os grupos aborto e controle. A citocina TNF&#945; está aumentada nos grupos de aborto em comparação ao controle. A taxa de metilação do DNA no gene IFNG foi correlacionada inversamente às concentrações de folato sérico e citocina IFN&#947; no grupo controle. E as concentrações de IL10 foram inversamente correlacionadas à taxa de metilação do DNA nos grupos de aborto secundário e controle. Neste trabalho, verificou-se que as vitaminas e as citocinas influenciam na taxa de metilação do DNA do gene IFNG e a citocina pró-inflamatória TNF&#945; apresenta-se aumentada em mulheres com história de aborto. / Recurrent spontaneous abortion (RSA) is characterized by the occurrence of three or more consecutive spontaneous abortions until the 20th week of gestation. It is a multifactorial pathological condition in which morphological uterine, endocrine disorders, changes in the karyotype genetic polymorphisms related to genes involved in homocysteine metabolism, infection, autoimmunity and inflammatory processes may contribute to the occurrence of RSA. The physiological state of the endometrium is essential for embryo implantation in the uterus during pregnancy. In maternal-fetal interface, there is a modulation of cytokines necessary for the establishment and development of placental angiogenesis. An imbalance between cytokines can decrease tolerance to fetus and cause fetal rejection. Concentration of cytokines may be modified due to a decrease in the expression of genes related to some of these cytokines that can be regulated by DNA methylation, which is an epigenetic mechanism of gene regulation and which corresponds to the incorporation of groups Methyl CpG islands located near the promoter regions of human genes, and this may be important in assessing the risk of pregnancy complications. In addition, the nutritional status of vitamins was associated with changes in the methylation pattern of certain genes. The aims of this study were to determine the concentrations of inflammatory mediators in women with abortion and the control group, examine correlations between concentrations of vitamins, total homocysteine and DNA methylation rate, examine correlations between cytokine concentration and DNA methylation and determine odds ratio (95% CI) of having abortion in multivariate models. We included 253 women with a history of recurrent miscarriage and 264 healthy women (control). DNA was extracted from peripheral blood leukocytes for the study of methylation. Serum and plasma aliquots were used for determination of vitamins, metabolites and cytokines. There were no differences in rates of DNA methylation between control and abortion groups. The cytokine TNF&#945; is increased in abortion groups compared to the control. DNA methylation rate in gene IFNG was inversely correlated with serum folate and serum cytokine IFN&#947; in the control group. Also IL10 concentrations were inversely correlated to DNA methylation rate in groups of miscarriage and secondary control. In this work, it was found that vitamins and cytokines influence DNA methylation rate in the promoter region and are different in the study and control groups.

Syftet med litteraturstudien var att belysa föräldrars erfarenheter av vården i samband med missfall. Missfall är en komplikation vid graviditet och förekommer i ungefär hälften av alla graviditeter. Vanligen söker föräldrar vård när kvinnan under sin graviditet får symtom på missfall. Vid missfall är känslor likt sorg, hjälplöshet, rädsla, ångest och att situationen är bortom kontroll vanligt förekommande, där föräldrarna kan ha svårt att släppa den förhoppning de byggt upp om framtiden. Det är viktigt att föräldrar vid och efter missfall får vård och stöd. Studien är en allmän litteraturstudie med induktiv ansats där vetenskapliga artiklar med kvalitativ design har analyserats. I resultatet framkom följande tre huvudkategorier: (1) Erfarenheter av sjukvårdsmiljön och vårdpersonalens bemötande, (2) Erfarenheter av information från vården samt (3) Erfarenheter av stöd från vården. Litteraturstudiens resultat visar att båda föräldrarna är i behov av vård vid missfall. Missfall innebär en stor emotionell och psykisk påverkan där båda föräldrarna upplever behov av bekräftelse, empati och förståelse från sjuksköterskan. Föräldrarna erfor en önskan om ytterligare information samt stöd i olika former. För att tillgodose föräldrarnas behov i samband med missfall ska sjuksköterskan informera, möta föräldrarnas tankar och funderingar, erbjuda och ge stöd samt uppföljningsvård efter missfall. / The aim of this study was to explore parents’ experience of healthcare in the event of miscarriage. Miscarriage is a complication of pregnancy and affects around half of every pregnancy. Care is often sought by the parents when the woman gets symptoms of miscarriage during pregnancy. Feelings like grief, helplessness, fear, anxious and the feeling that the situation is beyond control is common when miscarrying. The parents may have difficulties in letting expectations they built up for the future go. It is important that parents get care and support during and after the miscarriage. The study was conducted as a general literature study with an inductive approach, where scientific articles with a qualitative design where analysed. The result from the study emerged in three categories: (1) The experience of healthcare environment and the act by healthcare professionals, (2) Experience of information from healthcare and (3) Experience of support from healthcare. The result of the literature study shows that both parents are in need of care when miscarrying. Miscarriage imply both emotional and psychological impact on the parents, where both parents need confirmation, empathy and understanding from the nurse. The parents experienced a need of further information and further support in different forms. To fulfil good care and to meet the parents’ needs in the event of miscarriage, the nurse should inform, meet the parents and answer their questions and thoughts, offer and give support and follow-up care after miscarriage.

Bakgrund: Det är ungefär var tredje gravid kvinna drabbas av missfall. Många kvinnor har själv drabbats eller känner någon som har drabbats av missfall. Eftersom missfall kan vara sammankopplat med skuld och skam är sjuksköterskans bemötande viktigt för att kvinnorna ska kunna bearbeta sorgen. Syfte: Syftet var att beskriva kvinnors upplevelse av vårdersonalen vid missfall. Metod: En litteraturöversikt har genomförts där tio kvalitativa vetenskapliga artiklar och en artikel av mixad metod. Artiklarna hämtade från CINAHL Complete, Medline samt Psycinfo och har legat till grund för resultatet och analyserats enligt Fribergs metod Resultat: Resultatet framkom i fem olika teman vilka var (1) Kvinnors upplevelse av information från vårdpersonalen, (2) Kvinnors upplevelse av de olika vårdmottagningarna (3) Kvinnors upplevelse av vårdpersonalens bemötande, (4) Kvinnors reaktioner av missfall (5) Kvinnors upplevelse av stöd och uppföljning. Diskussion: Resultatets övergripande fynd handlade om kvinnor som drabbats av missfall och deras upplevelse av vårdavdelningarna och där ingick bemötande från vårdpersonalen och även utifrån sjuksköterskans perspektiv. Diskussionen förs relaterat till Swansons teori, reflektioner från författarna och bakgrunden till litteraturöversikten. / Background: It is common for a woman to suffer miscarriage. Most women have suffered or know someone who has suffered a miscarriage. Because a miscarriage may be associated with guilt and shame, the nurse's response is of great importance to a woman who needs to process the grief. Aim: The purpose was to describe women's experience of caregivers in case of miscarriage. Method: A literature review has been carried out where ten qualitative scientific articles and one article of mixed method. The articles were obtained from CINAHL Complete, Medline and Psycinfo and have been the basis for the results and analyzed according to Friberg's method Results: The results emerged in five different themes which were (1) The woman's experience of information from the care staff, (2) The women's experience of care environments, (3) The women's need for the various care departments and, (4) Women's reactions to miscarriage, (5) Women's experience of support and follow-up. Discussion: The overall finding of the result was about women who were affected by miscarriage and their experience of care units, treatment from the nursing staff and from the nurse's own perspective. Discussions are conducted related to Swanson's theory, reflections from the authors and the background to the literature review.