Phantom Pregnancy

Phantom Pregnancy: Is It a Reality?

                Pseudocyesis or false pregnancy is when a person believes that she is pregnant but not in real. It is also known as phantom pregnancy. A person with pseudocyesis has pregnancy symptoms and feels she is pregnant.

            However, pregnancy tests and ultrasounds proves that they aren’t physically pregnant, and no fetus is growing in their uterus Pseudocyesis is a rare condition where  the healthcare providers believe psychological and hormonal factors plays a major role in this condition.

How common is phantom pregnancy?

       Pseudocyesis condition are between 5-6 cases per 22,000 births. Most of these cases occur in patients between the age group 16 and 40 years. False pregnancy was more commonly seen before reliable pregnancy tests.

How it differs from real pregnancy?

      The   presence of fetus differentiates false pregnancy and real pregnancy. A person with pseudocyesis may feel pregnant and also have signs of pregnancy, but a pregnancy test, blood test or ultrasound will show they aren’t pregnant.

  What can you see in phantom pregnancy?

 Symptoms of pseudocyesis are similar to actual pregnancy because a person believes that they are pregnant or has a condition causing pregnancy symptoms. For example, some people will report that they have feeling of movement in their uterus.

Common symptoms & signs of false pregnancy:

  • Tenderness of breast
  • Enlarged abdomen.
  • Missed periods
  • Weight gain.
  • Morning sickness or nausea.
  • Cravings or aversions of food
  • False contractions in labor

           Medical experts aren’t sure what causes pseudocyesis but thinks that psychological and hormonal factors may contribute. This is a somatic symptom disorder or when a person has physical symptoms of a condition without any medical explanation.

What leads to a false pregnancy?

The conditions where a person may develop pseudocyesis are:

  • Strong desire to become pregnant.
  • Multiple abortion
  • Loss of a child.
  • Infertility
  • Extreme fear of becoming pregnant.
  • depression or anxiety.
  • Emotional trauma.
  • Sexual abuse.

Psychological factors play a role:

       The mind-body connection is so powerful.  Physicians believe that the urge to become pregnant is the most common cause of pseudocyesis.

   If people have a strong desire to become pregnant, their body helps them believe   they are pregnant.  Mental conditions like depression from infertility or abortion can be a risk factor for false pregnancy.

  • Overwhelming desire or fear of pregnancy
  • Loss of fertility or reproductive capacity
  • Mental/physical trauma
  • Psychiatric conditions
  • Anti psychotic drugs

Hormonal changes implicated:

        Pathological conditions like uterine tumors, cancer can cause changes in a person’s hormone levels. Hormonal changes can cause pregnancy symptoms like missed periods, fatigue or weight gain.

       Physicians has the responsibility to rule out these medical conditions before diagnosing   pseudocyesis. A strong desire for becoming pregnant may impact more on hormones directly and cause pregnancy symptoms.

How to find out this condition?

Doctors will perform a pelvic examination, ultrasound, urine or blood test to check for pregnancy. If a false pregnancy has occurred, these tests will become   negative and confirm that conception did not occur and the person isn’t pregnant.

People with this condition will be upset, disappointed and in disbelief that there is no fetus. An ultrasound is the best option for clearing out a person with pseudocyesis that they aren’t pregnant because it’s the most visual diagnostic test for pregnancy.

Some health conditions have the same symptoms that of pregnancy like a rare form of cancer which has the ability to secrete pregnancy hormones. Healthcare providers performs additional tests to rule out health conditions that may be a cause of pregnancy symptoms.

Features that help diagnosis:

  • To rule out viable pregnancy (pelvic exam, blood and urine test ,ultrasound)
  • Differential diagnosis (hyperprolactinemia, hormone secreting tumors, constipation, gallstones, delusions of pregnancy)

How to manage this situation ?

Treatment such as psychotherapy and pharmacotherapy help

  • Psychotherapy  and counselling  are the  efficient treatment  when individuals have  difficulty  in coming  to terms  with their false pregnancy, or remain symptomatic even after knowing  their  false  diagnosis.
  • It helps patients to confront the reality and accept the symptoms as illusions and provides an opportunity to solve other psychological stressors and trauma that may be responsible in manifestations of false pregnancy.
  • There is no direct evidence for treating false pregnancy with pharmacotherapy, but medications help to restore hormonal and neurotransmitter imbalances which are implicated in physical manifestations of false pregnancy. 
  • Reduced levels of catecholamine have been observed in people with symptoms such as hyperprolactinemia and abdominal distention.
  • For most of people, psychotherapy, pharmacotherapy (with antidepressants or antipsychotics), hormonal therapy, and uterine tissue removal are adequate to treat the condition.
  • Antipsychotics have been found to increase the lactation and amenorrhea   and can trigger delusions.  delusions are resolvable with medication changes or adjustments.
  • Gallstones, abdominal tumors, hyperprolactinemia are the medical conditions   which has been identified and treated may reduce the severity of the delusion.

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