Differential Diagnosis for Vaginal Bleeding in the First Trimester of Pregnancy
Single Most Likely Diagnosis
- Threatened abortion: This is the most common cause of vaginal bleeding in the first trimester, accounting for up to 50% of cases. It is essential to identify or rule out threatened abortion to determine the viability of the pregnancy and provide appropriate management to prevent miscarriage.
Other Likely Diagnoses
- Miscarriage: Miscarriage is another common cause of vaginal bleeding in the first trimester. Identifying or ruling out miscarriage is crucial to provide emotional support and manage any potential complications.
- Ectopic pregnancy: Although less common than threatened abortion or miscarriage, ectopic pregnancy is a significant cause of vaginal bleeding in the first trimester. It is vital to identify or rule out ectopic pregnancy to prevent life-threatening complications.
Do Not Miss Diagnoses
- Molar pregnancy: Although rare, molar pregnancy can cause vaginal bleeding in the first trimester. It is crucial to identify or rule out molar pregnancy to prevent potential complications, such as gestational trophoblastic disease.
- Placenta previa: Placenta previa can cause vaginal bleeding in the first trimester, and it is essential to identify or rule out this condition to prevent life-threatening bleeding and ensure appropriate management.
Rare Diagnoses
- Cervical polyps or cervical cancer: These conditions can cause vaginal bleeding in the first trimester, although they are rare. Identifying or ruling out these conditions is essential to provide appropriate management and prevent potential complications.
- Uterine rupture or dehiscence: Although extremely rare, uterine rupture or dehiscence can cause vaginal bleeding in the first trimester, particularly in women with a history of uterine surgery. It is crucial to identify or rule out this condition to prevent life-threatening complications.