Differential Diagnosis for Pelvic Pain in Pregnancy
Single Most Likely Diagnosis
- Round Ligament Pain: This is a common cause of pelvic pain in pregnancy, especially during the second trimester. It occurs due to the stretching of the round ligaments that support the uterus.
Other Likely Diagnoses
- Braxton Hicks Contractions: These are practice contractions that can cause pelvic pain and are more common as the pregnancy advances.
- Urinary Tract Infections (UTIs): UTIs are common in pregnancy due to physiological changes and can cause pelvic pain, dysuria, and frequency.
- Constipation: Constipation is a frequent complaint in pregnancy, which can lead to pelvic discomfort or pain.
Do Not Miss Diagnoses
- Placental Abruption: A life-threatening condition where the placenta separates from the uterus, causing severe abdominal and pelvic pain, and potentially leading to maternal and fetal distress.
- Preterm Labor: Regular uterine contractions leading to cervical dilation before 37 weeks of gestation, which can present with pelvic pain and requires immediate medical attention.
- Ectopic Pregnancy: Although less common in later pregnancy, ectopic pregnancy can still occur and is a medical emergency, presenting with severe pelvic pain, vaginal bleeding, and potentially shock.
- Ovarian Torsion: A rare but serious condition where the ovary twists, cutting off its blood supply, and can cause severe pelvic pain.
Rare Diagnoses
- Appendicitis: Although less common, appendicitis can occur during pregnancy and may present with atypical symptoms, including pelvic pain.
- Ureteral Stones: Kidney stones can cause severe pelvic pain and are more common during pregnancy due to urinary stasis.
- Adnexal Torsion: Similar to ovarian torsion but involves the twisting of the entire adnexa, which is rare but requires prompt surgical intervention.