PSEUDOCYESIS - FALSE PREGNANCY

............... False pregnancy, phantom pregnancy, or hysterical pregnancy—commonly called pseudocyesis in humans and pseudopregnancy in other mammals—is the appearance of clinical or subclinical signs and symptoms associated with pregnancy when the organism is not actually pregnant. I have encountered this condition more than once and I found it very interesting. I had a case of a woman who came in for regular maternal health clinic. She looked around 8 months pregnant and she was looking forward to the birth of her child. She was very faithful in ANC clinics and had already started shopping for baby clothes. She had however come with a note from another clinician who was surprised with the 'pregnancy' because Pregnancy Determination Test was negative severally. He had referred her for further follow-up and ultrasound. I examined her and she looked pregnant. She had missed her monthly menstrual periods by 8 months, the abdomen was markedly distended( almost a term pregnancy), her breasts were discharging milk and she had Linear nigra ( the prominent black line down from the umbilicus seen in pregnancy), the 'baby' was also kicking and she excitedly grab my hand and place it on the abdomen to feel the movements. Her face was puffy like that of a pregnant woman. There were however several catches. Though the abdomen was distended, I couldn't feel the hard gravid uterus. There was no palpable fundus. The 'kicks' were actually peristaltic movements(bowel movements) confirmed on  auscultation with my stethoscope. I talked to her further and I realized that she was  desperate for a baby. I tried to counsel her on the possibility that there was no pregnancy but she reminded me that she even had morning sickness in the first trimester and the abdomen had been increasing in size slowly over the months. She believed that the previous laboratory that did her pregnancy test had fake strips.  I decided to send her for a repeat pregnancy test and an 'obstetric' ultrasound. The results came out promptly. Pregnancy test was negative and the ultrasound was a normal one with a normal non-gravid uterus. There was no baby. An abdominal ultrasound was also done just to make sure that it wasn't an abdominal pregnancy and it was also a normal scan. I took to the task of counseling her further and telling her about a medical condition called PSEUDOCYESIS. It's a false pregnancy caused by the effect of stress on the hypothalamo-pituitary-adrenal axis causing hormonal changes that stimulate pregnancy-like changes in the body. She was so stressed and desperate for a child and the brain triggered a pregnancy-mode in the body. We had a similar case of a woman who came in labour pains for a 'term pregnancy' but the midwife nurse was surprised that the cervix was  closed despite the woman having very strong visible contractions for many hours. She also wasn't so sure about the uterus fundus because she couldn't feel it well but certainly there were contractions. From the history we were prepared for the worst and probably a caesarean section. A quick but thorough routine ultrasound was done and there was no pregnancy even though the contractions were real. The woman ofcourse cursed and blamed it on witchcraft by her enemies who had taken her baby from the womb in the last minute to delivery. But there was no witchcraft, the diagnosis was PSEUDOCYESIS in a woman so desperate for a baby. Pregnancy test was negative.   Back to my first patient, I started treatment for her and she accepted her condition albeit half heartedly. I prescribed to her antidepressants for the psychological problem and bromocriptine to arrest the milk production. She has been faithful in her monthly follow-ups for the last 6 months and slowly we have been successful in 'reversing' the pregnancy. The abdomen has markedly decreased in size, her face is no longer puffy, her monthly periods are back and the milk production has stopped . The baby 'kicks' have also disappeared.  I hope from this post on PSEUDOCYESIS we get to acknowledge the power of the mind.  If the mind is so powerful as to simulate a false pregnancy then imagine what more it can do. This reminds me of a quote that says;  'The greatest force is derived from the power of thought. The finer the element, the more powerful it is. The silent power of thought influences people even at a distance, because mind is one as well as many. The universe is a cobweb; minds are spiders. - Swami Vivekananda' I hope you have a lovely week ahead and get to utilize the power of the mind to achieve great things in life.