Differential Diagnosis
- Single most likely diagnosis:
- Incomplete abortion: This is the most likely diagnosis, as it is a common cause of vaginal bleeding and uterine cramping in early pregnancy. Incomplete abortion occurs when a miscarriage is in progress, but some fetal tissue remains in the uterus.
- Other Likely diagnoses:
- Threatened abortion: This condition is characterized by vaginal bleeding during the first 20 weeks of pregnancy, without cervical dilation or expulsion of fetal tissue. It is a possible diagnosis, but less likely than incomplete abortion if there is significant bleeding or cramping.
- Missed abortion: This occurs when a fetus has died, but remains in the uterus. It is a possible diagnosis, but may be less likely if there are symptoms of an ongoing miscarriage, such as cramping or bleeding.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Ectopic pregnancy: Although not listed as an option, ectopic pregnancy is a life-threatening condition that must be considered in any pregnant woman with abdominal pain or vaginal bleeding. It occurs when a fertilized egg implants outside the uterus, often in a fallopian tube.
- Complete hydatidiform mole: This is a rare condition in which a non-viable fertilized egg implants in the uterus and grows into an abnormal mass of tissue. It can cause severe bleeding, preeclampsia, and other complications if not diagnosed and treated promptly.
- Rare diagnoses:
- Normal pregnancy: While some vaginal bleeding can occur in a normal pregnancy, significant bleeding or cramping is not typical and would prompt further evaluation to rule out other conditions.
- Molar pregnancy with coexisting fetus: This is an extremely rare condition in which a molar pregnancy (such as a complete hydatidiform mole) occurs alongside a normal fetus. It is a rare and potentially life-threatening condition that requires prompt diagnosis and treatment.