Cryptic Pregnancy

Cryptic Pregnancy
Cryptic pregnancy is a condition whereby a pregnant woman is unaware of her pregnancy until labor. During this pregnancy there is little or no detectable Human chorionic Gonadotropin (hCG) in the mothers system.

Cryptic Pregnancy (Picture Credit; parents24.)

Very often, bodily symptoms of pregnancy (nausea, amenorrhea and abdomen swelling) are absent or greatly reduced, and neonates tend to be underweight; in many cases, pregnancy goes undetected also by relatives and physicians.

Cryptic pregnancy differs from to denial of pregnancy, a psychological condition, where the woman is subconsciously aware of her pregnancy, but denies its existence.

Some of these women do not know that they are indeed pregnant and some of them do know, but the medical community refuses to recognize that these pregnancies exist.

 It is estimated that about 1 in 450 pregnant women doesn't know her pregnancy status until 20 weeks/ 5months or later (more than halfway through the pregnancy), and 1 in 2,500 is unaware of her pregnancy until she actually goes into labor.


Causes

This can be medical, social or both
Medical;

• Hormonal imbalance as seen in:

           -Poly Cystic Ovarian Syndrome (PCOS).
           -Peri-menopause, which can begin as early as age 30, and go undetected.
           -Recently pregnant women whose hormones have not gone back to normal before getting pregnant again.
           -Lactating mothers whose hormones are not back to normal, before getting pregnant again.
           -Women with a very low body fat percentage, causing a hormonal imbalance, like in female athletes.
           -Women who have recently used or are currently using a birth control method such as the "Norplant", "Deprovera" Injection or the "Mirena Coil", that continually releases hormones into the body.

• Anterior Placenta; If the placenta is positioned at the front of the uterus (an anterior placenta), the baby’s movements may not be felt as plainly.

Social
    Ignorance: while most women understand that pregnancy means their periods will (probably) stop and that their bodies will change shape, not all women are well-informed enough to notice subtler signs such as breast tenderness, constipation, etc. If the woman does not gain much weight and she continues to bleed while pregnant, she may not realize she is pregnant.
    Believe: when a woman truly believes she cannot become pregnant (e.g due to her use of an IUD, or due to many years of trying without success), she can fail to correctly interpret fetal movement, and can convince herself it is just indigestion or gas.  

Signs and Symptoms Each woman has a different experience with cryptic pregnancy.

Here there may be Typical symptoms of pregnancy such as:
-Nausea/vomiting
-Fatigue
-Frequent urination
-Food aversion
-Increased appetite
-Weight gain
-Heart burn
-Back pain
-Metallic taste in mouth
-Abdominal cramping/round ligament pain
-Headaches

Atypical Symptoms such as;
-Negative urine and blood pregnancy tests
-Continued periods
-Weight loss (though this can also occur in a "standard" pregnancy)
-The pregnancy symptoms may come and go. You may not "feel" pregnant all the time. Oftentimes during the menstruation, the pregnancy symptoms will subside. As soon as the menstruation is over, the symptoms will begin again. This is a VERY strong sign of a cryptic pregnancy, especially during the first few months. 
-Early labor signs that occur off and on for weeks or even months (not preterm labor)
-An extended gestational period / pregnancy, typically of 17 months or longer   
-Slow growth of the abdomen/pregnant belly

Complications Of Cryptic Pregnancy
    -The possibility of birth defects
    -Blood type incompatibility between you and your baby
    -Hypertension
    -Preeclampsia
    -High Blood Pressure

Important Points To Note;

• In Cryptic pregnancy, ultrasound is mostly negative; showing the Uterus as normal and empty

• None of these babies have been born before 17 months and some have gone as long as 3 or 4 years. 
• Multiples are common with cryptic pregnancies
• The labor in these pregnancies are normally prodromal. This means the patient could be in labor off and on for weeks, even months. 

Diagnosis
 The use of Doppler which reads the baby's heartbeat to be at least 110 to 160 and a  Finger pulse which reads the patients heartbeat to be 80 or less,

Differential Diagnosis

• Ovarian cysts, 
• Fibroids,
• UTIs (urinary tract infection),
• PCOS (polycystic ovarian syndrome),  
• pre-mature menopause,  
• menopause,
• peri-menopause,
• phantom pregnancy

Periodic symptoms of Labor in cryptic pregnancyinclude;
Back pain- low or high
Nausea/vomiting
Headaches
Dizziness
Chills
Hot flashes
Cold sweats
Vision issues
Diarrhea
generalized body pain
pain radiating from the hips down to the legs
Sudden episodes of nausea followed by sudden intense hunger
Sudden urges to urinate;  incontinence to some extent
Palpitations
Heart burn
Over all tension and tightness in the entire torso
Metallic taste in mouth
Period type cramps- can become very intense
The entire vaginal area can ache and feel bruised
Swelling of vaginal walls- this happened because of increased blood flow to the area and can make the vagina feel tight and shorter
sharp shooting pains in the breast
Extreme thirst
Severe irritability
Sudden severe mood swings
Extreme fatigue
Severe constipation
Episodes of sudden energy or feeling uneasy
Strong Braxton Hicks contractions
Stabbing pains in the sides
Sharp pains, dull aches, pinches, tugs, pulls etc anywhere in the abdomen.
Cervical aches, pinches, burning and sharp pains that may feel like being stabbed with a needle

Some or all of this may be felt and it occurs intermittently. Some patients wake up in the middle of the night and suddenly have to push.

Once a diagnosis has been made, inform and counsel the patient.

(Picture Credit; amazing pregnancy pictures)

      




NOTES;

1  Cryptic Pregnancy Support Group |

2  Del Giudice, M. "The evolutionary biology of cryptic pregnancy: A re-appraisal of the "denied pregnancy" phenomenon.". Med Hypotheses. Retrieved 13 April 2013.

3  Jena, Pincot (8 November 2011). "How Can You Be Pregnant (For Months) And Not Know It?". Huffington Post. Retrieved 13 April 2013

4  Wikipedia | Cryptic pregnancy website