A phantom, or false, pregnancy, which is otherwise known as a pseudocyesis, is a condition in which a non-pregnant woman has all the symptoms of pregnancy and firmly believes that she is pregnant.
A woman who is suffering from a pseudocyesis will visit her doctor or the antenatal clinic complaining of all the symptoms and minor discomforts of early pregnancy, including absence of her periods, breast enlargement and breast changes, nausea and vomiting, increase of weight and abdominal distension. The clinical diagnosis of early pregnancy is extremely difficult, especially if such a person has a slightly enlarged uterus or is overweight, and it may be virtually impossible to confirm or deny the presence of a pregnancy by clinical examination alone. Since it is not the normal practice to perform pregnancy tests upon everybody who attends an antenatal clinic, she will probably be accepted as being pregnant and booked for confinement. The symptoms of pregnancy will continue and as the woman gains more weight she will become increasingly convinced about the presence of her pregnancy, although the fact that she is suffering from pseudocyesis may gradually become apparent to her.
True pseudocyesis is extremely rare and it must not be confused with a woman who, having missed one, or perhaps two periods, has no symptoms of pregnancy but visits her doctor to find out why she has missed them, and to ascertain whether or not she is pregnant. The very small group of women who suffer from pseudocyesis are convinced about their pregnancy. It is a condition that occurs mainly in women in their late thirties or early forties who desperately want a child and have been trying to become pregnant for many years. It can also occur in younger women—especially when relatives and friends are having babies or asking and joking about the girl’s ability to become pregnant. Women who suffer from false pregnancies are normally emotionally quite stable but may become very unstable over the question of pregnancy.
Pseudocyesis also occurs in some women who have lost a pregnancy or a baby. It may be an emotional reaction, but, in this case, there is increasing scientific evidence to indicate that a temporary hormone imbalance is the cause of all their symptoms.
The diagnosis of pseudocyesis is extremely difficult, especially at the beginning of a false pregnancy. The uterus will remain normal in size and successive pregnancy tests, if performed, will be negative. As the false pregnancy proceeds a marked increase in weight may occur, together with abdominal and breast enlargement, but the uterus will not enlarge nor will the breasts show active signs of pregnancy. None of the other physical signs of pregnancy will develop.
A woman who is suffering from true pseudocyesis will insist that she is pregnant despite the assurance that she is not. The problem requires very careful and sympathetic consideration with kindly explanation to the patient as to the reasons why she is not pregnant, together with appropriate proof that a pregnancy does not exist.
Severe emotional disturbance may follow the realization that she is suffering from a false pregnancy and the woman’s husband should also be acquainted with all the facts and treated with complete confidence, because his help is invaluable.