Differential Diagnosis for Shortness of Breath in Pregnancy
Single Most Likely Diagnosis
- Physiological dyspnea of pregnancy: This is the most common cause of shortness of breath in pregnancy, occurring due to the physiological changes of pregnancy, including increased blood volume, cardiac output, and pressure from the expanding uterus on the diaphragm.
Other Likely Diagnoses
- Asthma: Pre-existing asthma can worsen during pregnancy due to hormonal changes and may cause shortness of breath.
- Pneumonia: Pregnant women are at higher risk for developing pneumonia, which can cause shortness of breath, fever, and cough.
- Pulmonary embolism (low probability but important to consider): Although less common, pulmonary embolism is a significant concern in pregnancy due to increased blood clotting tendency.
- Anemia: Common in pregnancy, anemia can lead to shortness of breath due to reduced oxygen-carrying capacity of the blood.
- Cardiomyopathy: Peripartum cardiomyopathy is a rare but serious condition that can cause shortness of breath, among other symptoms.
Do Not Miss Diagnoses
- Pulmonary embolism: As mentioned, although less common, it is critical to consider due to its high mortality rate if missed.
- Amniotic fluid embolism: A rare but catastrophic condition that can cause sudden onset of shortness of breath, among other severe symptoms.
- Placenta previa or abruption: These conditions can cause significant bleeding and lead to shortness of breath due to hypovolemia and decreased oxygen delivery to tissues.
- Preeclampsia with pulmonary edema: A severe complication of preeclampsia that can cause shortness of breath.
Rare Diagnoses
- Idiopathic pulmonary arterial hypertension: A rare condition that can cause shortness of breath and is associated with high maternal and fetal morbidity and mortality.
- Lymphangioleiomyomatosis: A rare lung disease that can cause shortness of breath and is more commonly diagnosed in women of childbearing age.
- Cystic fibrosis: Although not exclusively a pregnancy-related condition, cystic fibrosis can complicate pregnancy and cause shortness of breath due to chronic lung disease.