Differential Diagnosis for Vaginal Bleeding in Pregnancy
Single Most Likely Diagnosis
- Threatened abortion: This is the most likely diagnosis given the patient's symptoms of vaginal bleeding and cramping in the first trimester. The presence of dark blood without clots is consistent with this diagnosis.
Other Likely Diagnoses
- Missed abortion: Although less likely than threatened abortion, missed abortion is a possibility, especially if the bleeding is due to a non-viable pregnancy that has not been expelled.
- Inevitable abortion: This diagnosis is also possible, as the patient's symptoms could indicate an impending miscarriage.
Do Not Miss Diagnoses
- Ectopic pregnancy: Although less common, ectopic pregnancy is a life-threatening condition that must be ruled out, especially if the patient presents with abdominal pain and vaginal bleeding.
- Placenta previa: This condition, characterized by the placenta covering the cervical os, can cause vaginal bleeding and is a significant concern due to the risk of severe hemorrhage.
- Molar pregnancy: A molar pregnancy can cause vaginal bleeding and is associated with an increased risk of gestational trophoblastic disease.
Rare Diagnoses
- Septic abortion: Although rare, septic abortion is a serious condition that can occur if the patient has an incomplete abortion and develops an infection.
- Uterine rupture: This is an extremely rare condition in the first trimester but can occur in women with a history of uterine surgery or other uterine anomalies.