Cryptic Pregnancy

By Chinenye H.G Ofokansi

Photo: change.org

We’ve heard stories of women who go into labour and gave birth spontaneously without knowing they are pregnant. TV shows like I didn’t know I was pregnant share stories of women who became mothers without preparation. All these are cases of cryptic pregnancies.

Cryptic pregnancy is a hidden or stealth pregnancy where the pregnancy eludes detection by the physician and sometimes the mother till birth.

There is a controversy in defining the meaning of cryptic pregnancy. Some authors believe that in cryptic pregnancy the woman who is pregnant is unaware she is pregnant; while some authors are of the view that women who are cryptically pregnant are aware of their state.

Cryptic pregnancy should not be misunderstood with pseudocyesis – which is false pregnancy.

There are a number of factors that could contribute to cryptic pregnancy.

1. Hormonal imbalance
Hormonal imbalance has been implicated in most studied cases of cryptic pregnancy. Hormonal imbalance at the time of implantation of a fetus could be as a result of:
a. stress
b. infection
c. polycystic ovarian syndrome (PCOS)
d. a recent pregnancy
e. breastfeeding
f. Low body fat/ low body mass index(BMI)

2. Polycystic Ovarian Syndrome
Polycystic Ovarian Syndrome (PCOS) is a hormonal disorder that results in enlarged ovaries with multiple cysts at the periphery of the ovary.

3. Perimenopause
Early perimenopause can occur as early as the age of 30.

4. Use of birth control pills eg Norplant, Deprovera injection or Morena Coil that gives steady release of hormones in the body.

5. Genetic trait
Cryptic pregnancy could be a genetic trait. It could be passed from mother to daughter. It runs in some families. There are instances where sisters experienced cryptic pregnancies.

Categories
I would categorize cryptic pregnancy into two:

1. Cryptic pregnancy where the pregnant woman does not know until she goes into labour. This happens in about 1 in 2500 pregnancies.

2. Cryptic pregnancy where the pregnant woman finds out along the line she is indeed pregnant either through medical testing or imaging. This happens in 1 in 475 pregnancies.

Signs and Symptoms
Cryptic pregnancy signs are spectacular. Normal pregnancies are confirmed using HCG based tests especially the rapid diagnostic tests. Cryptic pregnancies, however, might show a positive or negative pregnancy test – for both urine and blood. Most cryptic pregnancies show negative hCG for both urine and blood. Negative ultrasounds are also common in cryptic pregnancies. Like normal pregnancies, a cryptic pregnancy can have the following signs:

  • Nausea, which can be accompanied by vomiting
  • Urinary frequency(increased urination)
  • Backache
  • Food cravings in the first and third trimester
  • Food aversion in the first and third trimester
  • Extreme tiredness and fatigue in the first trimester
  • Metallic taste in the mouth.
  • Body changes: weight gain, changes around the abdomen. The stomach becomes harder and shows pregnant bump, which could be small compared to the gestational age.
  • Loss of menstrual cycles.

Typical Cryptic Pregnancy Symptoms

  • Negative blood and urine HCG tests.
  • Negative ultrasounds especially in women with retroverted uterus.
  • Pregnancy symptoms come on and off.
  • Spotting or continued menstrual bleeding.
  • Diminished fetal movement.
  • Protracted gestation due to slower fetal growth.
  • Prodromal labour.

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