Differential Diagnosis for 30 Weeks Gestation with Suprapubic Pain and Urinalysis Showing Blood and Leukocytes

• Single Most Likely Diagnosis
  • Urinary Tract Infection (UTI): This is the most likely diagnosis given the symptoms of suprapubic pain, hematuria (blood in urine), and leukocytes (white blood cells) in the urine. UTIs are common during pregnancy due to physiological changes that can predispose women to infection.
• Other Likely Diagnoses
  • Kidney Stones: Although less common than UTIs, kidney stones can cause severe pain and hematuria. Pregnancy increases the risk of stone formation due to increased urine concentration and other physiological changes.
  • Pyelonephritis: An infection of the kidney, pyelonephritis can present with flank pain, fever, and urinary symptoms similar to a UTI but is more severe and involves the upper urinary tract.
• Do Not Miss Diagnoses
  • Placental Abruption: Although the primary symptom is vaginal bleeding, placental abruption can sometimes present with abdominal pain and may be associated with hematuria if there is significant bleeding. It's a critical condition that requires immediate attention.
  • Preterm Labor: Suprapubic pain could be a symptom of preterm labor, especially if accompanied by regular uterine contractions. The presence of blood and leukocytes in the urine might be incidental or related to a urinary tract infection, but preterm labor is a condition that needs prompt recognition and management.
• Rare Diagnoses
  • Ureteral Injury or Rupture: This is a rare but serious condition that could present with severe pain and hematuria. It might be considered in the context of trauma or previous surgical interventions.
  • Malignancy: Although rare, malignancies such as bladder or renal cancer could present with hematuria and pain. However, these conditions are less likely in a pregnant woman without other risk factors or symptoms.