Differential Diagnosis for Spotting in 8 Weeks Gestational Age Pregnancy without Pain

Single Most Likely Diagnosis

• Threatened abortion: This is the most common cause of spotting in early pregnancy, especially in the absence of pain. It is often due to implantation of the embryo or hormonal changes.

Other Likely Diagnoses

• Implantation bleeding: This occurs when the embryo implants into the uterine lining, causing light bleeding or spotting.
• Cervical polyp or cervicitis: These conditions can cause spotting due to inflammation or irritation of the cervix.
• Hormonal changes: Fluctuations in hormone levels during early pregnancy can lead to spotting.

Do Not Miss Diagnoses

• Ectopic pregnancy: Although less likely without pain, ectopic pregnancy can present with minimal symptoms and is a life-threatening condition if missed.
• Molar pregnancy: A rare condition where the placenta grows abnormally, which can cause bleeding and requires prompt diagnosis and treatment.
• Placenta previa: A condition where the placenta covers the cervix, which can cause bleeding and is a significant risk factor for maternal and fetal morbidity.

Rare Diagnoses

• Uterine anomaly or septum: Congenital anomalies of the uterus can increase the risk of bleeding during pregnancy.
• Coagulopathy or bleeding disorder: Underlying bleeding disorders can increase the risk of spotting or bleeding during pregnancy.
• Infection: Rarely, infections such as chorioamnionitis can cause spotting in early pregnancy.