Abstract :
Pseudocyesis, false pregnancy, is a condition that has been known from the time of Hippocrates. In pseudocyesis, the woman truly believes she is pregnant and has objective signs and symptoms of pregnancy. The condition is also occasionally diagnosed in men. A case is reported of a 30-year-old woman who believed she was 13.5 weeks pregnant, had abdominal distension, and felt fetal movements. Examination revealed the absence of cervix and uterus. The woman had previously had two spontaneous abortions, no full-term pregnancies, and had undergone abdominal hysterectomy two years previously. The most widely accepted causes of pseudocyesis include: the conflict theory, a desire for or fear of pregnancy which causes internal conflict resulting in endocrine changes; the wish-fulfillment theory, affects susceptible individuals and pseudocyesis is triggered by minor body changes; and the depression theory, a major depressive disorder causing endocrine changes. Pseudocyesis has been reported to occur at a rate of one to six cases per 22,000 births. The average age of the patient is 33; 80 percent of affected women are married, and 37 percent have been pregnant at least once. The most common signs are abdominal enlargement, menstrual irregularities, sensation of fetal movements, gastrointestinal symptoms, breast changes, and labor pains. Elevated prolactin levels (a hormone which assists in stimulating the glands of the breast) have been suggested as a cause of many of the signs of pseudocyesis. The most successful treatment is to show the patient she is not pregnant by using abdominal imaging, counseling, and treating any underlying depression. (Consumer Summary produced by Reliance Medical Information, Inc.)