Introduction:
Cryptic pregnancy is a condition where the pregnant person is unaware of her pregnancy. This will be discovered late in pregnancy or when the labor pain starts. Women realize that they are pregnant between 4 and 12 weeks of pregnancy. They experience symptoms of pregnancy during this period. Pregnancy can be confirmed with a positive result on a pregnancy test. In a cryptic pregnancy, there will be no symptoms to believe they are pregnant.
Risk factors:
Women who recently gave birth: It may take several months for your menstruation to return after giving birth. There are no possible chances for ovulation if you are breastfeeding. This doesn’t mean that women are completely safe from pregnancy. It is difficult to predict when you will first ovulate during breastfeeding and become fertile.
Polycystic ovary syndrome (PCOS): Menstruation is unpredictable in people with PCOS. They may not realize that they are pregnant even if they miss their periods.
Use of birth control: Even if you use birth control, there is a small chance of getting pregnant.
Women who are in perimenopause: Women in their 40s think that they are too old to get pregnant. Sometimes, they mistake pregnancy symptoms for menopause symptoms.
Women who have never been pregnant: If you have never experienced pregnancy, you are less likely to know how pregnancy feels.
How common is a cryptic pregnancy?
Studies suggest about 1 in 475 pregnancies go unnoticed until 20 weeks of gestation. You won’t get a true menstrual period in a cryptic pregnancy. There are possible chances of implantation bleeding or abnormal pregnancy bleeding.
Causes:
A woman doesn’t experience pregnancy symptoms
A woman doesn’t know the symptoms and is not aware that they are pregnant.
A woman doesn’t notice the pregnancy symptoms
Signs:
Women with cryptic pregnancy experience similar symptoms as with normal pregnancy. Other signs include:
Missed periods
Spotting or light bleeding: Some women might experience light spotting in early pregnancy and mistake it for menstruation.
False negative pregnancy test: This means that the woman is pregnant but the pregnancy test is negative. It is always better to contact a healthcare provider to confirm a pregnancy.
Weight gain/swollen belly: Some people may not notice that they have gained weight due to being pregnant.
Fetal movement: Most women don’t feel the movement of the fetus until about halfway through pregnancy. The placenta is in front of your belly if you have an anterior pregnancy. This can hinder the ability to perceive fetal movements such as kicks.
Not aware of the symptoms of pregnancy: You may be unaware of the common signs of pregnancy like a missed period, tender breast, or nausea if you are very young.
How long does a cryptic pregnancy last?
There are cases where the person goes to the emergency room with pelvic pain only to discover that they are in labor. Cryptic pregnancies can result in preterm birth due to a lack of prenatal care, poor nutrition, or lifestyle choices.
Diagnosis and Tests:
Ultrasound
Blood test
Urine test
When a woman doesn't realize she's pregnant until she's well into the pregnancy or even until she goes into labor. It can happen due to various factors, including irregular periods, minimal weight gain, or lack of typical pregnancy symptoms. It's a rare phenomenon but can be surprising and challenging for those experiencing it.Dr Shweta Dilque, MBBS, MS OBG
Cryptic pregnancy can be divided into psychotic or non-psychotic types. The non-psychotic types can be further divided into:
Affective
Pervasive
Persistent
The psychotic type is associated with a psychotic disorder and is less common. The patient intellectually acknowledges the pregnancy in affective denial, but cannot declare the pregnancy.
The expectant person doesn’t know that they are pregnant in pervasive or persistent denial. There may be no symptoms like morning sickness, or weight gain. In rare cases like neonaticide, a dissociative episode might occur at delivery.
Management and Treatment:
Blood and urine tests
Ultrasound
Measuring fundal height
A physical examination
Nutritional and lifestyle counseling.
Prevention:
The best way to prevent cryptic pregnancy is to be aware of your body and sexual health. If there is any chance you could be pregnant, it is better to take a home pregnancy test or visit a healthcare provider.
Cryptic pregnancy management necessitates confirming pregnancy through various tests, providing psychological counseling, and promptly commencing prenatal care upon discovery to safeguard the well-being of both mother and baby. Healthcare providers must address any psychological factors underlying denial or unawareness. Vigilant monitoring during the pregnancy is essential to detect potential complications early on. This approach ensures optimal outcomes for both mother and child.Dr Shweta Dilque, MBBS, MS OBG
Case studies:
A 2011 review found that different population studies found the rate of cryptic pregnancy at 20 weeks to vary between 1 in 475 people to 1 in 516 people.
Another case report of cryptic pregnancy reveals a person experienced three days of lower back pain, abdominal discomfort, and constipation before going into labor.
Complications:
No pregnancy care: If you are not aware you are pregnant, you didn’t have the necessary bloodwork, nutritional counseling, ultrasounds, or other support needed for a healthy pregnancy.
Lifestyle adjustments: Smoking and alcohol consumption are harmful during pregnancy. If you are unaware of pregnancy, you may use these substances or any other medications that are not safe.
High risk of development of certain medical conditions like gestational diabetes or preeclampsia
High risk of development of congenital conditions
Conclusion:
Cryptic pregnancy represents a complex and frequently misconstrued aspect of reproductive health. Despite its infrequency, it warrants attention and comprehension from healthcare providers and society. Illuminating the nuances of cryptic pregnancy enables us to offer support and understanding to affected individuals, while also driving forward medical expertise for improved detection and care protocols in the future. Through heightened awareness, education, and empathy, we can traverse this mysterious journey with enhanced insight and compassion, ultimately nurturing a more inclusive and supportive atmosphere for everyone embarking on the journey to parenthood.
References:
1. "What is a Cryptic Pregnancy?". News-Medical.net. 2019-09-10. Retrieved 2019-11-12.
2. Goad, Kimberly. "Can You Be Pregnant and Not Know It?". WebMD. Retrieved 2019-11-12.