Is the spontaneous expulsion of a fetus that occurs before the 20th week of pregnancy?

A miscarriage, or “spontaneous abortion,” refers to the loss of a pregnancy before 20 weeks and occurs in 15 to 20 percent of all pregnancies. Most miscarriages occur during the first trimester but can also occur later on in the pregnancy.

Different types of miscarriages can occur at different stages of your pregnancy. The symptoms and treatments will depend on the type of miscarriage. Learn more about the different stages, signs and symptoms of, and treatment for miscarriage:

Chemical Pregnancy

A chemical pregnancy is a very early miscarriage which can occur before you even learn that you’re pregnant. As pregnancy tests have become more sensitive and more common, an increased number of chemical pregnancies have been diagnosed.

Chemical pregnancy is most likely the result of chromosomal abnormalities in the fertilized egg. An egg is fertilized, but is non-viable shortly after implantation, and is never visible on ultrasound.

Signs and Symptoms: There may be no signs of a chemical pregnancy. Most women simply begin to bleed around the time of their next period, though their period may arrive a few days late or be slightly heavier.

Blighted Ovum

Also known as anembryonic pregnancy, blighted ovum occurs very early in pregnancy, often before you even know you are pregnant. A fertilized egg attaches to the uterine wall, but an embryo does not develop.

Signs and Symptoms: You may feel signs of pregnancy, but when your doctor performs an ultrasound, he or she finds an empty gestational sac or cannot confirm a heartbeat.

You may miscarry the pregnancy or schedule a dilation and curettage (D&C) procedure, in which the cervix is opened, and the pregnancy is gently curetted, or removed, from the uterus.

Missed Miscarriage

A missed miscarriage, or a missed abortion, occurs when a fetus implants, but fails to develop.

The body does not expel the pregnancy tissue.

Signs and Symptoms: You may continue to feel signs of pregnancy if the placenta still releases hormones. Or, you may notice signs of pregnancy fade. Some women may experience some vaginal discharge and cramping, but many have no symptoms of miscarriage.

Sometimes the body will dispel the fetal tissue, but other times, a D&C procedure is necessary.

Threatened Miscarriage

A threatened miscarriage refers to vaginal bleeding that occurs during the first 20 weeks of pregnancy. It does not necessarily mean your pregnancy will end in a miscarriage — around half of threatened miscarriages result in a live birth.

Signs and Symptoms: Other symptoms of threatened miscarriage include lower back pain and abdominal cramps. If you have experienced unexplained bleeding during pregnancy, your doctor will want to perform an examination.

Cervix Dilation: In a threatened miscarriage, the cervix will remain closed. However, if an examination reveals the cervix has opened, a miscarriage is much more likely.

Inevitable Miscarriage

Inevitable miscarriage refers to unexplained vaginal bleeding and abdominal pain during early pregnancy.

Signs and Symptoms: Bleeding is heavier than with a threatened miscarriage and abdominal cramps more severe. Unlike threatened miscarriage, an inevitable miscarriage is also accompanied by dilation of the cervical canal. The open cervix is a sign that the body is in the process of miscarrying the pregnancy.

Incomplete Abortion

An incomplete abortion, which is also called an incomplete miscarriage, happens when some—but not all—of the pregnancy tissue is passed.

Signs and Symptoms: It is often accompanied by heavy vaginal bleeding and intense abdominal pain. The cervix will be open, and some remaining pregnancy tissue will be found in the uterus during an examination.

Complete Miscarriage

A complete miscarriage, also called a complete abortion, refers to a miscarriage in which all of the pregnancy tissue is expelled from the uterus.

Signs & Symptoms: A complete miscarriage is characterized by heavy vaginal bleeding, severe abdominal pain, and passage of pregnancy tissue. With a complete miscarriage, the bleeding and pain should subside quickly. Complete miscarriages can be confirmed through an ultrasound.

Dr. Alan Copperman is a board-certified reproductive endocrinologist and infertility specialist with a long history of success in treating infertility and applying fertility preservation technologies. He serves as Medical Director of Progyny, a leading fertility benefits management company, and co-founded and serves as Medical Director of RMA of New York, one of the largest and most prestigious IVF centers in the country. Dr. Copperman is also the Vice Chairman and Director of Infertility for the Icahn School of Medicine at Mount Sinai, and Chief Medical Officer of Sema4, a health information company. Dr. Copperman has been named to New York magazine’s list of Best Doctors 17 years in a row. He has been recognized by his peers and patient advocacy organizations for his commitment to patient-focused and data-driven care. He has published more than 100 original manuscripts and book chapters on reproductive medicine and has co-authored over 300 scientific abstracts on infertility, in vitro fertilization, egg freezing, ovum donation, and reproductive genetics.

Is a spontaneous expulsion of the fetus before the 20th week?

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