Differential Diagnosis for Syncope in a Pregnant Woman
Single Most Likely Diagnosis
- Vasovagal Syncope: This is the most common cause of syncope in pregnant women, often triggered by emotional stress, pain, or prolonged standing. The physiological changes of pregnancy, such as increased blood volume and venous distensibility, can exacerbate the vasovagal response.
Other Likely Diagnoses
- Orthostatic Hypotension: Due to the physiological changes of pregnancy, including venous pooling and decreased vascular tone, orthostatic hypotension is a common cause of syncope in pregnant women.
- Supine Hypotension Syndrome: Occurs when the pregnant uterus compresses the inferior vena cava, leading to decreased venous return and subsequent hypotension.
- Anemia: Common in pregnancy due to increased blood volume and demands for iron, anemia can lead to decreased oxygen delivery to tissues, including the brain, resulting in syncope.
Do Not Miss Diagnoses
- Pulmonary Embolism: Although less common, pulmonary embolism is a life-threatening condition that can cause syncope in pregnant women, particularly in those with risk factors such as thrombophilia or recent surgery.
- Cardiac Conditions: Such as arrhythmias, cardiomyopathy, or valvular disease, which can be exacerbated by the physiological changes of pregnancy.
- Preeclampsia: A condition characterized by hypertension and proteinuria, which can lead to cerebral vasospasm and syncope.
- Placenta Previa or Abruption: These conditions can cause significant bleeding, leading to hypovolemic shock and syncope.
Rare Diagnoses
- Neurocardiogenic Syncope: A rare condition characterized by an abnormal heart rate response to certain stimuli, leading to syncope.
- Long QT Syndrome: A genetic disorder that can cause life-threatening arrhythmias and syncope.
- Cervical Spine Injury: A rare cause of syncope in pregnant women, often due to trauma or underlying cervical spine disease.
- Migraine: Although not typically life-threatening, migraines can cause syncope in some cases, particularly if accompanied by aura symptoms.