What is the differential diagnosis for an irritable uterus at 21 weeks of gestation?

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Differential Diagnosis for Uterus Irritable at 21 Weeks

  • Single most likely diagnosis
    • Preterm labor: This is the most likely diagnosis, as an irritable uterus at 21 weeks can be a sign of preterm labor, which is a common cause of preterm birth.
  • Other Likely diagnoses
    • Braxton Hicks contractions: These are mild, irregular contractions that can occur during pregnancy, often causing an irritable uterus.
    • Uterine distension: As the uterus expands during pregnancy, it can become irritable due to stretching and pressure on the uterine muscles.
    • Fetal movement: Increased fetal movement can cause the uterus to become irritable, especially if the fetus is active or in a position that puts pressure on the uterine walls.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Placental abruption: This is a life-threatening condition where the placenta separates from the uterus, causing bleeding and depriving the fetus of oxygen and nutrients.
    • Uterine rupture: Although rare, uterine rupture can occur in women with a history of uterine surgery or previous uterine rupture, and can be catastrophic if not promptly diagnosed and treated.
    • Intrauterine infection: Infections such as chorioamnionitis can cause an irritable uterus and can be life-threatening to both the mother and the fetus if left untreated.
  • Rare diagnoses
    • Uterine anomalies: Certain uterine anomalies, such as a unicornuate uterus, can cause an irritable uterus due to abnormal uterine shape or function.
    • Uterine fibroids: Although not typically associated with an irritable uterus, large or multiple fibroids can cause uterine irritability, especially if they are degenerating or causing significant uterine distension.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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