Signs of false pregnancy and how does it end

Pregnancy is a unique experience for many mothers, but this experience may not end with the arrival of the child, as the mother may discover that what she was hoping for was not a real pregnancy. This condition is known as a false pregnancy. What is a false pregnancy? What are its symptoms? And how can it be distinguished from a real pregnancy? Follow us in this article from Dalili Medical to discover the answers.

Does a false pregnancy appear in a blood test?

A blood test can show positive results in the case of a false pregnancy, but this percentage is low, although the urine test may give negative results.

How long does a false pregnancy last?

Symptoms of a false pregnancy can last for a few weeks, or even nine months, and in some cases they may last for several years. Some women may arrive at the hospital due to pain similar to labor pains. Early detection and follow-up are the best solution to differentiate between a normal pregnancy and a false pregnancy, as the tests performed by the doctor, such as ultrasound, physical examination, and pelvic examination, help to confirm the presence of a fetus or not.

What is a false pregnancy?

Pseudocyesis is a condition in which a woman experiences all the symptoms of a normal pregnancy, except for the presence of an actual fetus. Interestingly, this phenomenon is not limited to women only, but can also occur in men, where this condition is called "couvade". Men in this condition experience symptoms similar to those of pregnancy, such as nausea, weight gain, and back pain, and this often occurs when their wives are pregnant and suffer from pregnancy-related aches.

How can I know if I have a false pregnancy?

An ultrasound image can be used to confirm the presence of an empty pregnancy, i.e. the presence of a gestational sac without a fetus. If the gestational sac is seen to be devoid of any signs of a fetus, such as a yolk sac or fetal pole, there is a possibility of a phantom pregnancy, depending on the age of the pregnancy.

What are the causes of the failure of the fetus to form in cases of anembryonic pregnancy?

The main reason for the failure of the fetus to form in cases of false pregnancy is the presence of chromosomal problems or disorders in the egg cells, which may result from the advanced age of the woman or man. In other words, the likelihood of cell division problems or chromosomal disorders increases with age. Some conditions such as poor egg or sperm quality can also negatively affect pregnancy.

Who are the women most at risk of having a false pregnancy?

Women who become pregnant before the age of 20 or after the age of 35, or who have a history of false pregnancy, are more likely to face this problem than others.

Does high prolactin levels cause false pregnancy?

Prolactin levels increase during pregnancy in order to stimulate milk production after birth. Prolactin levels and their production rate are directly related to pregnancy in women, and they also affect sex hormones in both men and women (such as estrogen and progesterone).

It should be noted here that high prolactin levels are not related to false pregnancy or pregnancy without a fetus, as this situation occurs when the fertilized egg attaches to the uterine wall without a fetus forming. It is necessary to investigate the causes of high prolactin levels. The increase in this hormone prevents the secretion of estrogen, which leads to irregular menstrual cycles, thus preventing proper ovulation. However, many women regain their ability to conceive and get rid of menstrual disorders after starting treatment to lower prolactin levels.

What is the method of treatment after a nulliparous pregnancy?

After aborting the tissue resulting from an empty pregnancy, some measures must be taken, including blood and urine tests to measure the level of HCG. If some abnormal cells persist in the uterus, the level of this hormone will not decrease, which requires additional treatments to ensure full recovery.

Can a false pregnancy be aborted?

The idea of aborting a false pregnancy is illogical, as there is no fetus or even a fertilized egg, so a woman cannot get rid of something that does not exist in the first place.

What is the marital relationship like after experiencing a phantom pregnancy?

After experiencing a false pregnancy, there are no restrictions on practicing marital relations, except in the event of possible bleeding. However, it is preferable to postpone thinking about having children for a certain period to avoid any problems that may arise in the next pregnancy. Also, if necessary, complementary treatments should be completed to get rid of abnormal cells in the uterus, in addition to taking birth control pills according to the doctor's instructions.

Is there a chance of having children after a false pregnancy?

Yes, a normal pregnancy and childbirth can occur after experiencing a false pregnancy once. However, it is preferable to wait for a period ranging from 6 to 12 months before trying to have children, with the need to follow up the case under the supervision of a specialist doctor throughout the new pregnancy.

Does an ectopic pregnancy end naturally?

Usually, a phantom pregnancy ends on its own, as the mother's body recognizes the condition and terminates the pregnancy. The appearance of blood spots and abdominal pain after the onset of pregnancy may indicate the presence of an ectopic pregnancy, which can be aborted naturally or require medical intervention. In the case of an empty sac pregnancy, no fetus is formed, but only the placenta grows. This condition occurs when the sperm enters an empty egg, which leads to the fetus not forming and the pregnancy continuing abnormally.

Should I have a curettage in case of a false pregnancy or wait for a natural abortion?

During the ultrasound examination, the doctor measures the size of the gestational sac and looks for the presence of an embryo or a yolk sac. If the diameter of the sac is larger than 20 mm without an embryo, this indicates a false pregnancy. It is also necessary to examine the gestational sac through the wave image.

Can a false pregnancy recur?

Experiments indicate that anembryonic pregnancy usually occursIn most cases, it is only once, which means that there is no need to look for the reason for its occurrence the first time. However, an empty sac pregnancy can be classified as a recurrent miscarriage, and if it is diagnosed late or if immediate treatment such as curettage is not taken, it may take longer.

In general, and given that genetic causes are often behind the occurrence of a phantom pregnancy, the chances of a successful pregnancy in the future can be assessed by conducting special tests, as the possibility of a false pregnancy occurring again ranges from 1 to 2%.

When does a false pregnancy end and miscarriage occur?

A false pregnancy usually ends with a miscarriage before the twentieth week of pregnancy. However, if the woman is not aware of her pregnancy and does not see a doctor for a long time, this problem may not be diagnosed, which leads to prolonging the time before the miscarriage occurs.

Does an empty sac pregnancy cause cancer?

An empty sac pregnancy does not lead to any type of cancer, but it may sometimes turn into a cancerous gestational trophoblastic tumor (GTD) that requires different treatments.

What is a false pregnancy or gestational sac without a yolk sac?

The gestational sac usually forms in the fourth or fifth week after fertilization, surrounding the yolk sac, placenta, and fetus. However, if the yolk sac is not seen inside the gestational sac, this indicates that the fetus has not formed, although the woman may feel pregnancy symptoms. This type of pregnancy is known as a false or phantom pregnancy, and it often miscarries in the first trimester.

Does a woman feel nauseous in a phantom pregnancy?

Although the fetus is not formed in an anembryonic pregnancy, the placenta is formed, which leads to the secretion of the hormone HCG in the mother's blood, which causes the appearance of common pregnancy symptoms, including nausea.

What is the difference between a false pregnancy and a normal pregnancy?

Although women who suffer from a false pregnancy may experience symptoms similar to those that appear in a normal pregnancy, they can be distinguished through a physical examination, where the doctor examines the pelvis to confirm the presence of pregnancy. Ultrasound also helps distinguish between a normal pregnancy and a false pregnancy, as it shows the absence of a fetus in the case of a false pregnancy.

**Causes of false pregnancy**

False pregnancy cases are rare, making it difficult to determine the real causes behind them. There are three main theories that explain the most important causes, which are as follows:

. **Psychological factors and false pregnancy**: Psychological factors can lead to false pregnancy, especially in cases where a woman is approaching menopause, delayed marriage, or delayed pregnancy after marriage. Even women who suffer from infertility may feel symptoms of false pregnancy as a result of their intense desire to have children.

. **Endocrine disorders and false pregnancy**: When pregnancy is delayed or thoughts about it increase, this can affect the hormones secreted by the pituitary gland. This may lead to the secretion of hormones from the endocrine glands that cause the menstrual cycle to stop and the appearance of symptoms similar to pregnancy, but in fact they indicate a false pregnancy and not a real pregnancy.

. **False pregnancy in menopause**: A woman reaching menopause and her fear of not being able to have children may lead her to imagine that she is pregnant, which makes her feel the symptoms of real pregnancy.

. **Tumors (molar pregnancy): Tumors may be present inside the uterus, whether malignant (cancer) or non-malignant, causing symptoms of false pregnancy, and this is detected by the doctor.

Tumors (molar pregnancy): A tumor may appear inside the uterus, whether malignant (cancer) or non-malignant, leading to symptoms of false pregnancy, and this is diagnosed by the doctor.

Pseudopregnancy and gestational sac: It occurs when the gestational sac is not complete or there is a defect in the placenta or fertilized egg, which prevents the egg from turning into a fetus. Nourishing fluids are formed in the placenta, but without the presence of a fetus, leading to symptoms of false pregnancy.

Schizophrenia: Patients with schizophrenia are at risk of false pregnancy due to the instability of their psychological state, as the woman may feel symptoms of real pregnancy, while it is in fact a false pregnancy.

**Ovarian cysts:** Ovarian cysts occur when cysts form inside the ovaries, which may lead to a positive result on the pregnancy test indicating the presence of pregnancy. However, the reality of pregnancy can be confirmed through accurate medical examinations using modern devices.

**Fertilization dysfunction in males:** Fertilization dysfunction refers to the failure of the sperm to fertilize the egg, which leads to the egg moving inside the tubes without implanting in the uterine wall. As a result, the cells responsible for the growth of the fetus stop due to the incomplete fertilization process, which makes the pregnancy test appear as if there is a real pregnancy.

**Recurrent miscarriage as one of the causes of false pregnancy:** Recurrent miscarriage can be another cause of false pregnancy.

**Signs of false pregnancy**

In general, the symptoms of false pregnancy are similar to those that appear in a normal pregnancy, but there are special signs that distinguish a phantom pregnancy, and their severity varies from one woman to another. Among the symptoms that can be indicated are:

- Feeling nauseous and vomiting severely.

- Vaginal bleeding in a dark or light brown color during the first trimester of pregnancy.

- Feeling pain or pressure in the pelvic area and lower abdomen, but in rare cases.

- Inability to hear the fetal heartbeat or record its movement.

- The appearance of thyroid problems, such as hyperthyroidism in some cases.

- High levels of HCG hormone.

- The appearance of problems such as high blood pressure or early preeclampsia.

- Increased levels of protein in the urine after the twentieth week of pregnancy.

- Anemia.

- Seeing cysts on the ovaries.

- Rapid and abnormal growth of the uterus.

- The emergence of cysts that resemble clusters of grapes.

- Cases of preeclampsia.

**Common symptoms between false pregnancy and normal pregnancy**

Syptoms that may appear in KSymptoms of false pregnancy and normal pregnancy include:

- Nausea

- Feeling pain in the abdomen and sides

- High HCG levels

- Feeling tired and weak

- Pain in the breasts

- Feeling hungry Therefore, these symptoms should not be relied upon alone to diagnose false pregnancy, but additional tests are necessary.

**In what week can false pregnancy be diagnosed?**

If a woman suffers from false pregnancy, no fetus will appear on the ultrasound image during the seventh week. It is important to note that the fetus may sometimes not be seen due to an error in calculating the gestational age, even if the pregnancy is normal. For example, if the ultrasound image is performed in the fifth week, assuming that it is the seventh week, this is common and normal.

Therefore, if there is uncertainty about the gestational age and the corpus luteum does not appear on the ultrasound image, the doctor will request a re-examination after several days or weeks to confirm whether or not there is a false pregnancy.

In general, the doctor confirms the presence of an ectopic pregnancy in ultrasound images starting from the seventh or ninth week, by checking the following cases:

- Absence of amniotic fluid

- Absence of sperm or fetus

- Presence of cysts in the ovaries

- Uterus filled with thick cystic placenta

**Size of the gestational sac in cases of empty pregnancy**

In a normal pregnancy, the fetus can be seen inside the gestational sac approximately at the sixth week, where the diameter of the sac is about 18 mm. In cases of false pregnancy, the fetus does not appear inside the sac despite its continued growth. If the diameter of the gestational sac is 4 mm and no fetus is seen, this indicates an empty gestational sac. In general, the size of the gestational sac is measured during an ultrasound examination in the following cases:

- If the diameter of the gestational sac is more than 20 mm and the fetus is not seen, this indicates a false pregnancy, in which case a vaginal examination should be performed to verify the situation.

- If the diameter of the sac is less than 20 mm, the pregnancy may still be in the early stages, and the examination should be repeated after a week or two.

How to terminate a false pregnancy?

There is no treatment that can lead to the formation of a fetus in the case of a false pregnancy, and eventually the miscarriage occurs naturally. However, if the miscarriage does not occur spontaneously, the doctor can use the following methods to terminate this pregnancy:

1. **Medications to abort a phantom pregnancy**: Some medications such as Misoprostol are used to stimulate the uterus to abort and terminate the false pregnancy.

2. **Monitoring and controlling the HCG hormone after the miscarriage**: The HCG hormone level should be measured (through a blood or urine test) several times after the termination of a pregnancy that does not contain a fetus until it returns to its normal level.

3. **Curtage to terminate a phantom pregnancy**: During the abortion process, it is preferable to wait until the body expels the abnormal tissue naturally. However, a curettage may be required to take a sample of the placenta for a histopathological test to determine the cause of the miscarriage. It is important that the curettage is performed by a specialist doctor experienced in uterine curettage techniques to avoid any uterine rupture.

**Diagnosis of false pregnancy**

False pregnancy is diagnosed by performing tests similar to those used to diagnose normal pregnancy, including the following tests:

1. **Physical examination**: This includes a pelvic examination to confirm the presence of pregnancy.

2. **Urine test**: The test result usually appears negative in cases of false pregnancy, except in some rare cases in which the woman may have a type of cancer that affects pregnancy hormones in the body.

3. **Ultrasound examination**: It is considered one of the basic tests for diagnosing false pregnancy, as it can confirm the absence of an actual fetus. In some cases, thinning of the uterine wall may appear, which is one of the symptoms associated with pregnancy, but in the end, the doctor has the ability to accurately diagnose the condition.

**Methods of treating false pregnancy**

. **Pregnancy monitoring**: Pregnancy should be followed up with the doctor to determine whether it is real or false, which helps in taking appropriate medical measures. Therefore, it is recommended to visit the doctor when feeling pregnancy symptoms to confirm their nature, and to start treatment early if the pregnancy is false.

. **Uterine curettage**: If the pregnancy is at an advanced stage, the doctor may perform a uterine curettage to get rid of pregnancy components such as the placenta and fluids.

. **False birth**: If the pregnancy continues to its end, the doctor may perform a delivery without a fetus, to get rid of the consequences of a false pregnancy.

. **Pregnancy test pills**: These pills are used to stimulate the menstrual cycle (menstruation) and get rid of the effects of a false pregnancy.

. **Regulating the menstrual cycle**: It is important to visit a doctor to regulate the menstrual cycle, as amenorrhea is a symptom of a false pregnancy.

. **Regulating endocrine hormones**: Changes in endocrine hormones play a role in stopping the menstrual cycle, which requires regulating it.

. **Hysterectomy**: A hysterectomy is performed if the false pregnancy is caused by a malignant tumor (such as a molar pregnancy) inside the uterine wall.

. **Tumorectomy**: If the false pregnancy is caused by a non-malignant tumor, this tumor is removed from inside the uterus.

. **Medical prescriptions**: The doctor may prescribe some medications and intramuscular injections that help get rid of false pregnancy and its effects.

. **Enhncing the psychological state**: In some cases, false pregnancy is associated with an unstable psychological state, such as stress due to menopause, delayed pregnancy, or repeated miscarriage. Therefore, it is important to support the psychological state of the woman with false pregnancy to avoid the recurrence of this condition, as false pregnancy is an imaginary condition that arises as a result of delusions.

How can a husband deal with his wife who has been diagnosed with false pregnancy?

The husband may feel that he is facing a great challenge in this case, so we offer some tips that may help him deal with this situation:

Open**: It is important to create a safe environment that allows both spouses to express their feelings, concerns, and negative and positive thoughts about pregnancy.

2. **Active listening**: The husband should listen to his wife carefully and show interest in her feelings, while trying to understand what she is going through even if it seems illogical.

3. **Seeking psychological support**: It is useful to consult a psychologist to help her overcome her psychological state and understand the dimensions of the problem more deeply, which makes it easier to manage it in a scientific way.

4. **Providing emotional support and participation**: The husband can accompany his wife on doctor visits, and pay attention to his instructions, which enhances trust and familiarity between them.

5. **Encouraging the search for appropriate treatment**: The husband should support his wife in searching for appropriate treatment, as psychological treatment can be effective in cases of false pregnancy, as mental health specialists help treat the psychological condition as one of the most important treatment methods to get rid of this condition permanently.

Diagnosis of false pregnancy