Differential Diagnosis for Contraction Pain at 28 Weeks
- Single Most Likely Diagnosis
- Braxton Hicks contractions: These are mild, intermittent contractions that occur in the second and third trimesters of pregnancy, often increasing in frequency and intensity as the pregnancy advances. They are a normal part of pregnancy and preparation for labor.
- Other Likely Diagnoses
- Preterm labor: Regular, intense contractions that lead to cervical dilation before 37 weeks of gestation. At 28 weeks, this is a significant concern due to the risks associated with preterm birth.
- Urinary tract infection (UTI): UTIs can cause discomfort that may feel like contractions, especially if the infection involves the kidneys (pyelonephritis).
- Do Not Miss Diagnoses
- Placental abruption: A serious condition where the placenta separates from the uterus, which can cause severe abdominal pain and contractions. It is a medical emergency.
- Uterine rupture: Although rare, this is a life-threatening condition where the uterus tears, which can cause severe pain and contractions. It's more common in women with a previous uterine scar (e.g., from a cesarean section).
- Preeclampsia: A condition characterized by high blood pressure and often protein in the urine, which can lead to severe complications for both mother and baby. It may cause abdominal pain and contractions.
- Rare Diagnoses
- Uterine dehiscence: A partial tear of the uterine wall, which is less severe than a rupture but can still cause significant pain and complications.
- Round ligament pain: While more common in the second trimester, round ligament pain can occur at any time and may feel like contractions as the ligaments stretch to accommodate the growing uterus.