Differential Diagnosis
- Single most likely diagnosis:
- Normal early pregnancy: The patient's symptoms of mild fatigue and nausea are consistent with early pregnancy, and the ultrasound confirmation of a 7-week intrauterine fetal pole with cardiac motion supports this diagnosis. The patient's overall health, diet, and lifestyle also suggest a low-risk pregnancy.
- Other Likely diagnoses:
- Hyperemesis gravidarum (mild form): Although the patient reports no vomiting, some women with hyperemesis gravidarum may experience only nausea. However, the absence of vomiting and the patient's ability to maintain her daily activities make this less likely.
- Nutritional deficiencies: The patient's restrictive diet, although rich in vegetables and fish, may lead to nutritional deficiencies, such as iron or B12 deficiency, which can cause fatigue and other symptoms.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Ectopic pregnancy: Although the ultrasound shows an intrauterine fetal pole, it is essential to rule out ectopic pregnancy, especially if the patient's symptoms worsen or if there are any signs of vaginal bleeding or pelvic pain.
- Molar pregnancy: Although rare, a molar pregnancy can present with similar symptoms and must be considered, especially if the patient's ultrasound or beta-hCG levels are abnormal.
- Thyroid dysfunction: Thyroid disorders, such as hyperthyroidism or hypothyroidism, can cause fatigue, nausea, and other symptoms similar to those experienced in early pregnancy.
- Rare diagnoses:
- Pregnancy-related complications (e.g., placenta previa, vasa previa): These complications are rare but can cause significant morbidity and mortality if not diagnosed and managed promptly.
- Gestational trophoblastic disease: This rare condition can present with similar symptoms and must be considered if the patient's ultrasound or beta-hCG levels are abnormal.