Differential Diagnosis for a Third Trimester Pregnant Woman with Cough
- Single Most Likely Diagnosis
- Upper Respiratory Tract Infection (URTI): This is the most common cause of cough in pregnancy, similar to the general population. Pregnancy itself does not significantly alter the risk of common colds or other viral upper respiratory infections.
- Other Likely Diagnoses
- Asthma: Pregnancy can affect asthma control, and cough is a common symptom. Existing asthma may worsen, improve, or remain unchanged during pregnancy.
- Pregnancy-induced hypertension or preeclampsia with pulmonary edema: Although less common, these conditions can present with cough among other symptoms like shortness of breath.
- Gastroesophageal reflux disease (GERD): Symptoms of GERD, including cough, can be exacerbated during pregnancy due to increased intra-abdominal pressure.
- Do Not Miss Diagnoses
- Pneumonia: Although not as common, pneumonia is a critical diagnosis to consider due to its potential severity, especially in pregnant women whose immune response may be altered.
- Pulmonary embolism: This is a life-threatening condition that requires immediate diagnosis and treatment. Pregnancy increases the risk of venous thromboembolism.
- Influenza: Especially during flu season, influenza can be severe in pregnant women and should be considered, particularly if the cough is accompanied by fever, body aches, and other systemic symptoms.
- Rare Diagnoses
- Cystic fibrosis: Although rare, cystic fibrosis can present with chronic cough and should be considered in women with a history suggestive of the disease or with unexplained recurrent respiratory infections.
- Sarcoidosis: This autoimmune disease can affect the lungs and cause cough, among other symptoms. It is less common but should be considered in the differential diagnosis of a persistent cough.
- Tuberculosis: Especially in areas with high prevalence or in individuals with risk factors (e.g., recent travel, exposure), TB should be considered as it can present with chronic cough.