Differential Diagnosis for Cervical Pregnancy
When differentiating cervical pregnancy, it's crucial to consider various conditions that may present similarly. Here's a categorized differential diagnosis:
Single Most Likely Diagnosis
- Ectopic pregnancy: This is the most likely diagnosis to consider when suspecting a cervical pregnancy, as both conditions involve abnormal implantation of the embryo outside the uterine cavity. A thorough ultrasound examination can help differentiate between the two.
Other Likely Diagnoses
- Spontaneous abortion: Vaginal bleeding and abdominal pain in early pregnancy can also be indicative of a spontaneous abortion, which may be mistaken for a cervical pregnancy.
- Molar pregnancy: Although less common, a molar pregnancy can cause similar symptoms, such as vaginal bleeding and abnormal uterine enlargement.
- Placenta previa: This condition, characterized by the placenta covering the cervical os, can cause vaginal bleeding and may be considered in the differential diagnosis.
Do Not Miss Diagnoses
- Uterine rupture: Although rare, uterine rupture can occur in women with a history of uterine surgery or previous cervical pregnancy, and it's essential to rule out this life-threatening condition.
- Ovarian torsion: Severe abdominal pain can also be a symptom of ovarian torsion, which requires prompt surgical intervention to preserve ovarian function.
- Ruptured corpus luteum cyst: This condition can cause severe abdominal pain and vaginal bleeding, mimicking the symptoms of a cervical pregnancy.
Rare Diagnoses
- Cervical malignancy: Although extremely rare, cervical cancer can cause abnormal vaginal bleeding and may be considered in the differential diagnosis, especially in older women or those with a history of cervical dysplasia.
- Metastatic disease: In rare cases, metastatic disease from other primary sites can involve the cervix and cause symptoms similar to those of a cervical pregnancy.
- Cervical polyp or fibroid: Benign growths, such as polyps or fibroids, can cause abnormal vaginal bleeding and may be mistaken for a cervical pregnancy.