Differential Diagnosis for Natalie's Uterine Contractions
Natalie is experiencing uterine contractions during her 7th month of pregnancy. The following differential diagnosis is organized into categories to help guide the thought process:
Single Most Likely Diagnosis
- Preterm Labor: This is the most likely diagnosis, as uterine contractions during the 7th month of pregnancy (before 37 weeks of gestation) can be a sign of preterm labor. Preterm labor is a common cause of uterine contractions in the second and third trimesters.
Other Likely Diagnoses
- Braxton Hicks Contractions: These are false labor pains that can occur during the second and third trimesters. They are usually irregular, mild, and do not lead to cervical dilation.
- Uterine Irritability: This can be caused by a variety of factors, including dehydration, urinary tract infections, or fetal movement.
Do Not Miss Diagnoses
- Placental Abruption: This is a life-threatening condition where the placenta separates from the uterus, causing uterine contractions, vaginal bleeding, and fetal distress. It is essential to rule out this condition due to its high morbidity and mortality.
- Uterine Rupture: Although rare, uterine rupture can occur in women with a history of uterine surgery or previous uterine rupture, and can cause severe uterine contractions, abdominal pain, and fetal distress.
Rare Diagnoses
- Uterine Dehiscence: This is a rare condition where there is a partial separation of the uterine scar, usually in women with a history of uterine surgery. It can cause uterine contractions, abdominal pain, and fetal distress.
- Chorioamnionitis: This is a rare infection of the amniotic fluid and placenta, which can cause uterine contractions, fever, and fetal distress.