What are the Causes & Symptoms of a False Pregnancy?

False Pregnancy or Pseudocyesis

False Pregnancy or Pseudocyesis is the belief that one is expecting a baby though the person is not carrying a child. It's also referred to as Phantom Pregnancy, Delusional Pregnancy or Hysterical Pregnancy. Females with false pregnancy have many, if not all, pregnancy symptoms, except one, i.e., the presence of an actual foetus in the womb.

In some rare cases, men too experience pregnancy-like symptoms called Couvade Syndrome or Sympathetic Pregnancy.

Causes of False Pregnancy

Various psychological and physical causes work in a loop and lead to the false belief that one is pregnant.

Psychological Causes that lead to false pregnancy

1) When a female experiences a strong desire to get pregnant, her body may produce pregnancy-like symptoms. The strong desire could be because of infertility, repeated miscarriages, delay in marriage or impending menopause. Such circumstances affect the hormone balance leading to the production of signs like a distended belly, enlarged breasts and, in some cases, the sensation of foetal movements. The female's brain believes those signs as pregnancy, and in reciprocal, hormones such as oestrogen and prolactin are released that lead to false pregnancy symptoms.

2) Poverty, a lack of education, childhood sexual abuse or relationship problems may trigger false pregnancy.

3) Depression resulting from any reason may lead a female to believe that she's pregnant. Antipsychotic drugs lead to increased prolactin levels that further induce pregnancy-like symptoms.

4) Other mental traumas like schizophrenia, personality disorders or mood disorders too may lead to the false perception that a lady is pregnant.

5) Stress, fear, anticipation or other emotional disturbances lead to increased central nervous system activity inducing pregnancy symptoms like distended abdomen, foetal movement sensation and assumed contraction.

Physical Causes that cause false pregnancy

1) Morbid obesity may mimic pregnancy.

2) Ovarian or Pituitary tumours lead to increased hormone production that further increases oestrogen and prolactin levels, leading to pregnancy-like symptoms.

3) Medical conditions like gallstones, abdominal tumours, constipation, tubal cysts may mimic pregnancy or produce pregnancy-like signs and symptoms.

False Positive Pregnancy Test leads the patient to believe that she's pregnant.

A false positive pregnancy test may lead the woman to believe that she's pregnant though she's not technically pregnant.

The chances of a false positive pregnancy test occur in the following cases.

1) Chemical Pregnancy

This happens when a fertilised egg or embryo can not implant in the uterine wall and grow.

2) Ectopic Pregnancy

When a fertilised egg implants in the fallopian tube or the cervix, ovary or somewhere in the abdominal cavity. This is an emergency that requires immediate medical intervention.

3) Recent miscarriage or abortion

In these cases, the hCG levels in the blood and urine are still on the upward trend as they normally rise to the sixth week. An ultrasound and subsequent D/C are needed in these cases.

4) User error

The self-use pregnancy test kits aren't foolproof. Not following the instructions properly might lead to false-positive pregnancy tests.

5) Medications

Females on fertility medications may get a false positive pregnancy test due to synthetic hCG in their blood.

6) Medical conditions like Molar Pregnancy, Urinary Tract Infections, Kidney Diseases or Ovarian or Pituitary cancer may lead to false-positive pregnancy tests.

Symptoms of False Pregnancy

The symptoms of False Pregnancy are the same as those pregnant.

1) Enlarged or distended abdomen. The navel stays inverted contrary to real pregnancy in which the navel gets everted.

2) Interruption of or delayed menstrual periods.

3) Enlarged and tender breasts accompanied by changes in nipples and in some cases, milk production too is present.

4) Sensation of foetal movements, which are peristaltic.

5) Weight gain.

6) Nausea and vomiting.

7) Increased urinary frequency.

8) Food cravings

9) The most important symptom that will confirm that the pregnancy is false is the report of abdominal ultrasound that will reveal the absence of the foetus.

10) A negative urine pregnancy test will also confirm that the pregnancy is false.

Treatment of False Pregnancy

The only and best way to convince a woman that she isn't pregnant is her ultrasound image which will confirm the absence of the foetus in the womb. Since a false pregnancy is just an illusion, no treatment and/or medication is required.
In case of menstrual irregularities, medication for the same will be needed.
When the false pregnancy is caused by other medical conditions like ovarian or pituitary tumours or morbid constipation, the relevant treatment will lead to the omission of the pregnancy-like symptoms.
In the case of women suffering from psychological instability and severe depression, consulting a psychotherapist will help solve the problem.

Summary

False Pregnancy is a rare phenomenon that may be confusing to the patient. When the patient is confronted with reality, it can be emotionally draining for her.

False-positive pregnancy tests are not the only issue. False-negative pregnancy tests are prevalent too that lead a woman to believe that she isn't pregnant though, in reality, she is.

The various causes that lead to false negative pregnancy test are:-

1)Test taken too early. Ideally, it's advised that the home kit test be taken one week after missing the periods.

2)The test results are checked too soon. The kit is provided with an instruction manual that mentions the time needed for the appearance of the second pink or blue line. If the woman doesn't wait for that much time, it will lead to a false negative pregnancy test.

3) Drinking too much water can lead to a false negative pregnancy test.

4) Incorrect use of pregnancy test kits.

5) Miscalculated menstrual cycle can lead to a false negative pregnancy test.

6)Diluted hCG levels can mislead the results.

It's advisable that whenever one experiences pregnancy signs and symptoms or takes a pregnancy home test, whatever the result, a laboratory test should be taken. In addition to that, being in touch with a medical expert is mandatory. The expertise of a doctor helps one clear the doubts and guides toward taking the right steps.

References

Ibekwe PC, Achor JU. (2008). Psychosocial and cultural aspects of pseudocyesis. www.ncbi.nlm.nih.gov