April 6, 2010

Pseudocyesis - False Pregnancy

For the second time in my career as a labor and delivery nurse, I took care of a woman who said she was 28 weeks pregnant...but wasn't actually pregnant. She had everyone fooled. She came in by ambulance with several complaints and the only one OB related was abdominal pain. She wasn't happy to have been brought up to OB because she said she wasn't worried about the baby because she just had a sonogram a week ago and that he was moving all over the place. So I get to work to verify that she was fine obstetrically, but I was unable to find fetal hearttones. She was a larger woman, but appeared obviously pregnant. Her t-shirt appeared wet from leaking colostrum and when I did Leopold's, it felt like her baby was lying towards her left side. I grab a doppler, and again try to find the baby. No luck, but it sounds like there is movement in her abdomen. Generally, when you use a doppler to locate FHT's on a non-pregnant woman, or a woman with a fetal demise, you can hear her bowels moving, but it's pretty quiet. It really sounded like there was movement in there. I had 2 other people try - something I don't normally do because if I can't find FHT's, you worry it's a demise and all it does is stress the patient and the OB needs to come in. But I was sure I was hearing fetal movement. None of us had any luck. The patient didn't seem concerned because she said they have a hard time in the office, too. After trying for quite awhile, I call the city call OB (her OB doesn't practice at Hospital). He orders a OB sono to confirm the pregnancy is fine. At this point, I jokingly said to my coworkers "Maybe she isn't pregnant". But boy, was I surprised when the sono tech looked up and said "I don't see a pregnancy. I'll use the transvaginal to get a better look." Nope, nothing. Never was pregnant. No baby, no yolk sac, fetal pole, no nothing. Not even a large cyst. I wondered if maybe she had delivered recently and something happened and the baby died and she didn't tell anyone, but based on the report, it didn't appear she had been pregnant anytime recently. Not sure how they can tell that, but I'm not a sonographer. I felt pretty dumb because I really didn't think it was possible she wasn't pregnant. She had a large gravid-appearing abdomen, appeared to be leaking colostrum. And she insisted that she had a sonogram a week ago and everything is fine and then said "My babies never show up on the sonogram and they are fine". Complete denial. I believe she was the first case of pseudocyesis that I've seen. (The other case was someone who obviously knew she wasn't pregnant and she never let us evaluate her before she left AMA.) This woman was convinced she was pregnant and believed so whole heartedly that she appeared pregnant, had hormonal changes that cause colostrum to form and as for the "fetal movement", she must have some crazy gas in there. The "mass" was probably stool, hopefully nothing more serious. A couple times, I've felt gas moving around in my bowels that seriously felt like a baby running it's leg across my abdomen, when I was not pregnant. It was very eerie. I discharged her to the ER and I hope she sees a psychiatrist. We will be extra vigilant in the next few months with infant safety. People who claim they are pregnant but are not are at risk of trying to kidnap a baby. I'm still a bit in awe. I don't know what is going on in her life that she would claim to be pregnant, but I hope she gets the help that she needs.

12 comments:

Cherry said...

Wow, I've heard of that before, I don't know what I'd do in your shoes! Congratulations on the little bug!! I'm glad things are going well this time around. Praying for a healthy pregnancy and delivery for you! Our sons are around the same age. It's nice to know what other people's 2 year olds are like.

AtYourCervix said...

We've seen a few cases of pseudocyesis. One kept insisting that we took her baby, because she was pregnant, by gosh! "Where's my baby??" she was wailing. Very sad. We also have a specific person (who has been caught on surveillance by several hospitals) who has a variety of pregnancy histories/current pregnancy statements - who, as far as we know, has never had a baby. Sometimes it's twins, sometimes triplets. She's on our security watch list for risk for infant abduction. Very, very sad.

Erykah said...

Did you read about the case where the resident OB induced a non-pregnant woman and then did a c/s on her since the induction (obviously) failed? Its a crazy world out there.
http://www.theunnecesarean.com/blog/2010/3/30/doctors-induced-and-performed-cesarean-on-non-pregnant-woman.html

Nurse Lochia said...

Wow, first let me say I can tell I typed that post after waking up...really need to proofread or wake up more first!

Ok, yeah, I read about the c-section on a non-pregnant woman and I still don't understand how that happened. It didn't take us long at all to figure out she wasn't pregnant...sono was pretty clear. In that case, I wonder what they thought the presenting part was when they checked her cervix. Did anyone do a sono? Check her cervix? Some will have a heartrate that is fast enough that it looks like it could be a fetal heartrate...but that's part of the labor nurses job...to verify that the heartbeat you are getting is not maternal. I am still amazed that someone got as far as being induced and "delivered: by c/s without someone realizing she wasn't pregnant.

trooppetrie said...

how did she respond when you told her she was never pragnant. did you call her OB and ask. i wonder if she had even seen a dR

Anonymous said...

my SIL just did this.. it's really sad i feel bad for her, but she is still convinced she was pregnant.. i think there should be some sort of law to admit these women because they need help and when they're still in denial there is no helping them.. it's scary!

Anonymous said...

Hi. I think i am going through phantom pregnancy. I should have started my period on the 3rd of November. Today is the 14th, no period. I took a pregnancy test on the 8th, 12th and 13th and all were negetavie. I have pregnancy symptomes: nausea, bigger breasts, headaces, moody, no period and smell. I never had morning sickness with my daughter. I am wondering what i should do now? I really need help...

Miz Marta said...
This comment has been removed by the author.
MN P said...

A lot of woman are going through this. Unfortunately there are misleading websites out there like the "cryptic pregnancy" one's giving these poor woman false hope. I say this because I myself felt for it as "Becky Done" who is now getting help for her pseudocyesis condition as I did too. I mean can anyone really be pregnant more than 9 months or way over 42 weeks? Only god can answer that question I guess. I mean I myself believed I was going through a cryptic pregnancy myself, I thought doctors were just wrong. After going to 4 different doctors over a period of 1 yr I realized I was the wrong one. I could just swear I had fetal movements, big growing breast, constipation, nausea, backache- you name it I had All the pregnancy symptoms. I felt ashamed especially since I had told everyone in my family as friends. So if I went through this I can imagine all the others who are convinced they are pregnant too. It is sad and heartbreaking and I don't wish this on anyone. A friend of mines also had same thing as me and she was not really pregnant either. Cryptic Pregnancy are RARE as seen in I didn't know I was pregnant where these births were preterm or full term and not more according to hospital medical doctors. They were also UNAWARE of such pregnancies. People are going to believe what they want to believe, the mind is a powerful tool and once your convinced your pregnant so will your body even though one really is not. I wish all these woman luck and the best, eventually we all will come to reality at one point or another, I am happy I did. Doctors are NOT evil after all, nor bad as many say.

Anonymous said...

"People who claim they are pregnant but are not are at risk of trying to kidnap a baby." I'm sorry, who says that? Where is this statistics from? Or you just assumed that? I had period-like bleeding (but lighter and shorter) during my pregnancy + my tests came out negative till 6th month. My belly didn't stop growing with few more symptoms. doctors and even my friends thought I was making this up, but it turned out I wasn't. Stop doing this. I hate people when they think they know everything. I'm not telling all these women are actually pregnant, but I'm telling doctors only know what they were thought as "normal" and they can be wrong. They turned my life into hell, and I'm reading lots of stories like mine. So sick of it.

Anonymous said...

Oh and this phantom pregnancy has nothing to do with mental illness. It can happen to anyone. There is no direct link between mental illness and phantom pregnancy. You don't need to afraid of these women bcoz they are most likely kidnap babies. But you all need to educate yourselves.

Anonymous said...

I was DX with this pseudodioses in Feb. at 13 weeks by my calculation (from conception) I was sure I was pregnant. But, he gave me a 10 second US of my uterus and assertively, almost angrily, said " NO baby, nothing in the uterus, not pregnant! you shouldn't be here in the ER taking up my time!" In shame I took myself out of there. I stopped believing I'm pregnant, I ignored it, but my waist kept growing. I look like I'm pregnant, now it would be 25 weeks, I feel movement. But, I'm not according to the 2 ER docs in Feb. i keep telling myself it's a mass and not a baby. I've gained 27 lbs. and have a 40 inch waist, I was a size 2 and 105 lbs before this. They found a mass that was 3 x 3.5 x 2 inches near my left kidney in Feb, I believed it must be a baby because I had been sick repeatedly in Dec and Jan, and had extreme abd pain and dry heaves. I had two ectopic and lost one tube previously, so I believed it was an extrauterine pregnancy. Doc made me feel crazy, scolded me for going to ER for non-emergent pain. CT scan didn't show a baby. So, I have a second US set for Friday, which will show a mass or a baby or what? Nothing but fat? I don't know. I just know that this isn't normal, the weight gain, the discomfort, the nausea, the pain in my right side. I feel defeated, like I've created this in my mind and my body's rolling with it, but I never wanted to be pregnant, I'm 49yo and in pre menopause, I don't know why or how I could have this mental condition, I question my sanity.