Differential Diagnosis for Progressively Worsening Vomiting in a Clomiphene Induced Pregnancy
Single Most Likely Diagnosis
- Hyperemesis gravidarum: This condition is characterized by severe nausea and vomiting that is more extreme than typical morning sickness. It is a common complication in early pregnancy, especially in women who have conceived through fertility treatments like clomiphene. The seven-week timeline fits within the typical onset period for hyperemesis gravidarum.
Other Likely Diagnoses
- Gastroesophageal reflux disease (GERD): Pregnancy can exacerbate GERD symptoms due to increased pressure on the stomach and relaxation of the lower esophageal sphincter, leading to vomiting.
- Urinary tract infection (UTI): Although not directly related to vomiting, UTIs can cause nausea and vomiting, especially if the infection has progressed to pyelonephritis.
- Food poisoning or viral gastroenteritis: These conditions can cause acute vomiting but might not fully explain a seven-week progression without other symptoms.
Do Not Miss Diagnoses
- Preeclampsia: Although typically presenting later in pregnancy, preeclampsia can occasionally manifest early with non-specific symptoms like nausea and vomiting. It's crucial to monitor blood pressure and urine protein.
- Molar pregnancy: A rare condition where the placenta develops into an abnormal mass of cysts, it can cause severe nausea and vomiting due to high hCG levels.
- Appendicitis: Abdominal pain and vomiting can be symptoms of appendicitis, which requires immediate surgical intervention to prevent rupture.
- Pancreatitis: Inflammation of the pancreas can cause severe vomiting and abdominal pain, requiring prompt medical attention.
Rare Diagnoses
- Thyrotoxicosis: Hyperthyroidism can cause nausea, vomiting, and weight loss. Although rare, it's essential to consider, especially if there are other symptoms like palpitations or heat intolerance.
- Adrenal insufficiency: A rare condition where the adrenal glands do not produce enough cortisol and aldosterone, leading to nausea, vomiting, and potentially life-threatening complications if not treated.
- Neurological conditions (e.g., vestibular disorders, migraines): These can cause nausea and vomiting but are less likely to be directly related to the pregnancy itself.