Differentials
Placental abruption
SIGNS / SYMPTOMS
This can occur with or without vaginal bleeding (concealed abruption). Signs of fetal distress (abnormal fetal heart rate pattern) or the presence of blood in the vagina increase its likelihood. It may also lead to preterm labor.
INVESTIGATIONS
A nonstress test may reveal an abnormal fetal heart rate pattern.
Kleihauer test: this blood test demonstrates fetal cells in the maternal circulation.
Urinary tract infection (UTI)
SIGNS / SYMPTOMS
A previous history of UTI, abdominal pain, dysuria, or increased frequency of urination. This may lead to preterm labor.
INVESTIGATIONS
Urinalysis for nitrites, leukocytes, and protein.
Urine culture: positive growth of specific microorganism.
Ovarian cyst
SIGNS / SYMPTOMS
Can mimic preterm labor. May have nonspecific signs of abdominal pain or backache. May present with tachycardia, low BP, nausea and vomiting, or localized abdominal pain.
INVESTIGATIONS
Ultrasound pelvis: may reveal an ovarian mass or free fluid in the abdomen.
Ovarian torsion
SIGNS / SYMPTOMS
Can mimic preterm labor. May present with nonspecific abdominal or back pain and associated symptoms of nausea and vomiting.
INVESTIGATIONS
Ultrasound pelvis: may reveal an ovarian mass or free fluid in the abdomen.
CT abdomen: generally avoided in pregnancy but will demonstrate ovarian torsion.
Appendicitis
SIGNS / SYMPTOMS
Abdominal pain may be higher in the abdomen and more diffuse. May have accompanying symptoms of nausea, vomiting, and loss of appetite.
INVESTIGATIONS
Ultrasound abdomen: may reveal an appendix mass.
WBC and CRP may be elevated.
Use of this content is subject to our disclaimer