Differential Diagnosis for Pelvic Cramping in 2nd Trimester
Single Most Likely Diagnosis
- Braxton Hicks contractions: These are mild, intermittent contractions that occur in the second and third trimesters, preparing the uterus for labor. They are the most common cause of pelvic cramping in the second trimester and are usually benign.
Other Likely Diagnoses
- Round ligament pain: As the uterus expands, the round ligaments that support it can stretch and cause pain, often felt as a sharp, stabbing sensation in the lower abdomen or pelvis.
- Urinary tract infection (UTI): UTIs can cause pelvic cramping, especially if the infection has ascended to the kidneys.
- Constipation: Constipation is common during pregnancy due to hormonal changes and can cause pelvic discomfort or cramping.
Do Not Miss Diagnoses
- Placental abruption: A life-threatening condition where the placenta separates from the uterus, causing severe abdominal pain, vaginal bleeding, and potentially compromising fetal well-being.
- Preterm labor: Regular uterine contractions that lead to cervical dilation before 37 weeks of gestation, which can result in premature birth.
- Uterine rupture: A rare but catastrophic event where the uterus tears, often in women with a previous uterine scar, which can be life-threatening for both mother and fetus.
- Ovarian torsion: A condition where the ovary twists around its ligaments, cutting off blood supply, which requires immediate surgical intervention.
Rare Diagnoses
- Appendicitis: Although less common during pregnancy, appendicitis can occur and may present with atypical symptoms, making diagnosis challenging.
- Adnexal torsion: Similar to ovarian torsion but involves the twisting of the entire adnexal structure, including the fallopian tube and ovary.
- Uterine dehiscence: A partial separation of a previous uterine scar, which can cause pelvic pain and may progress to uterine rupture if not addressed.