Test Your Knowledge

The types of miscarriage are classified according to the physical signs a physician notes upon examination of a woman:

• Threatened miscarriage. A woman has vaginal bleeding early in pregnancy, but her cervix has not begun to dilate. This condition, however, does not mean that a miscarriage will occur. In many women with threatened miscarriage, the bleeding subsides and the pregnancy continues to term. In such cases, physicians may order complete bed rest for a few weeks (or until delivery) to ensure continuation of pregnancy. Rarely, the bleeding becomes heavier and miscarriage follows.
  

  

• Inevitable miscarriage. A woman has vaginal bleeding accompanied by contractions of her uterus and dilation of the cervix. This type of miscarriage cannot be prevented.
  
  
• Incomplete miscarriage. A woman has expelled most of the pregnancy tissue through her vagina, but some remains in the uterus. Typically, the fetus has been passed, but bits and pieces of the placenta may remain inside the uterus. In this type of miscarriage, the cervix remains open, and bleeding may be heavy, usually requiring some intervention.
  
  
• Complete miscarriage. A woman has a miscarriage and none of the tissue from the pregnancy remains in her uterus. This is common in miscarriages that occur before 12 weeks of pregnancy. After the miscarriage, a woman experiences bleeding and cramping that resolves without medical intervention. On examination, a physician typically finds that the cervix is closed, and there is no sign of a pregnancy sac in the uterus. Ultrasound examination may be used to confirm the diagnosis.
  
  
• Septic miscarriage. A miscarriage is accompanied by an infection in the uterus. Symptoms include fever, chills, abdominal pain, vaginal bleeding and vaginal discharge, which may be thick and have an unpleasant odor.
  
  
• Missed abortion. A miscarriage in which the fetus died prior to the 20 weeks of gestation, but neither the fetus or placenta were expelled by the uterus. In these cases, interventions may be offered but the tissue may be spontaneously expelled within a short time frame.
  
  
• Recurrent miscarriage. A woman experiences the loss of two or more consecutive pregnancies in the first or second trimester OR the loss of three or more pregnancies before 20 weeks gestation.
  
  
• Blighted ovum. This occurs when a gestational sac forms inside a woman’s uterus, but no fetus is present after seven weeks.
  
  
• Molar pregnancy. This is a rare condition that is also known as gestational trophoblastic disease. It occurs when a pregnancy results in the growth of abnormal tissue rather than an embryo, and it typically ends in miscarriage before the fourth month of pregnancy. In a few cases, it may result in uterine cancer.