Differential Diagnosis
- Single most likely diagnosis
- Pseudocystis or False Pregnancy: This condition is characterized by a false belief of being pregnant, often accompanied by symptoms such as morning sickness, abdominal distension, and breast fullness. The patient's positive home pregnancy test, followed by negative office urine pregnancy tests, and the absence of an embryo on bedside ultrasound examination support this diagnosis. The patient's history of trying to conceive for 3 years and her strong desire for pregnancy may have contributed to her false belief.
- Other Likely diagnoses
- Early Miscominging or Miscarriage: Although the patient had a positive home pregnancy test, it is possible that she had a very early miscarriage, which could explain the negative office urine pregnancy tests and the absence of an embryo on ultrasound.
- Incorrect Dating of Pregnancy: If the patient's last menstrual period was not accurately dated, it may be too early to detect the pregnancy on ultrasound or urine tests.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Ectopic Pregnancy: Although less likely, an ectopic pregnancy can present with similar symptoms and must be ruled out to avoid missing a potentially life-threatening condition.
- Molar Pregnancy: A molar pregnancy can also cause symptoms such as morning sickness and abdominal distension, and although rare, it is essential to consider this diagnosis to provide appropriate management.
- Rare diagnoses
- Ovarian Tumor or Cyst: A large ovarian tumor or cyst can cause abdominal distension and mimic the symptoms of pregnancy.
- Gastrointestinal Disorders: Certain gastrointestinal disorders, such as irritable bowel syndrome or inflammatory bowel disease, can cause abdominal distension and other symptoms that may be mistaken for pregnancy.