Pseudocyesis (spurious pregnancy

OBSTETRICS
Lecture: 3.
Fourth Year Medical College.
Lecturer: Professor Layla Abdul Amir.

Pseudocyesis (spurious pregnancy):
Is a psychological disorder in which has a false but fixed belief that she is pregnant. May be associated with gross psychoses as schizophrenia or with long history of infertility, but more common cases not associated with such sever mental illness. Usually it is seen near or after menopause. There may be amenorrhoea and the patient declare that she has morning sickness.
Abdominal distension may occur due to:
1. Collection of gas in stomach.
2. Intestinal distension.
3. Persistent contraction of diaphragm with exaggerated lumbar lordosis.
4. Fat.
Breast tenderness occur due to chronic mastitis. Usually there is no fetal parts, no fetal heart sounds.
Diagnosis of previous pregnancy:
1. Pigmentation of the breast areola.
2. Abdominal striae.
3. Muscles become stretched.
4. External cervical os is slid like and not very round.
Estimation of the expected date of delivery:
If the women is pregnant fort first time called primigravida. If it is for multiple pregnancies called multigravida. Any pregnancy is called gravida.
Any delivery or pregnancy continue after 28 week is called para (no mater whether baby a live or dead). Any pregnancy terminated before 28 week is called abortion.
e.g. if women comes to the clinic and she said that she had seven pregnancies, but only three times delivered, then we say that she has: gravid 7, para 3, abortion 4.
For estimation of expected delivery date there is a simple practical method is to count forward nine calendar months (or backwards three months) from the first day of the last menstrual period.
e.g. Last menstrual period: 1 - 7 - 1995
So we add to the day 7: +7
And cut 3 from months: –3
8 - 4 - 1997
If the menstrual period regular and the women not on hormonal therapy, so determine of E.D.D will be easy. But if the women is under hormonal therapy and irregular menstrual period, usually the calculation of the E.D.D is wrong, so in this case we depended on:
1. Follow them up with development of the baby by observation the height of fundus and movement of the fetus till we estimate E.D.D.
2. Ultra sound scan: which is quick, safe and accurate method of dating pregnancy especially in the first 20 week.
3. Hormone assay: it is useful in assessment of gestational age at four to six weeks of pregnancy.