Differential Diagnosis for Vomiting in Pregnancy
Single Most Likely Diagnosis
- Hyperemesis Gravidarum: This is the most common cause of vomiting in pregnancy, especially during the first trimester. It is characterized by excessive vomiting, leading to dehydration and weight loss.
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.
- Food Poisoning: Similar to the general population, pregnant women can experience vomiting due to food poisoning, which can be caused by consuming contaminated food or drinks.
- Gastroenteritis: Viral or bacterial infections can cause gastroenteritis, leading to vomiting, diarrhea, and abdominal cramps in pregnant women.
Do Not Miss Diagnoses
- Preeclampsia: Although less common, preeclampsia can present with vomiting, especially if it progresses to severe preeclampsia or HELLP syndrome. Missing this diagnosis can be life-threatening for both the mother and the fetus.
- Appendicitis: Appendicitis can cause vomiting and abdominal pain. In pregnancy, the appendix may be displaced upward, potentially altering the typical presentation and making diagnosis more challenging.
- Urinary Tract Infection (UTI): A UTI can cause vomiting, especially if it progresses to pyelonephritis. UTIs are more common in pregnancy due to physiological changes.
Rare Diagnoses
- Hydatidiform Mole: A rare condition where a non-viable fertilized egg implants in the uterus, leading to excessive vomiting, among other symptoms.
- Multiple Pregnancy: Carrying twins or other multiples can increase the severity of morning sickness and vomiting due to higher levels of human chorionic gonadotropin (hCG).
- Adrenal Insufficiency: Although rare, adrenal insufficiency can cause vomiting, and its diagnosis is critical due to the potential for severe consequences if left untreated.