Pseudocyesis Leads to C-section in North Carolina

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Two doctors in Fayetteville, North Carolina are receiving disciplinary action related to the performance of a cesarean section on a woman in 2008 who was not pregnant, but suffering from pseudocyesis, also called false or hysterical pregnancy.

The incident occurred at Cape Fear Medical Center, when a woman presented at the hospital with her husband asking for a C-section. The physicians, Dr. Gerianne Geszler and Dr. Dorrette Grant, agreed to the surgery after attempting to induce labor for two days with unsuccessful results. Neither doctor confirmed the pregnancy.

The physicians have received a letter of concern from the North Carolina Medical Board, the lowest level of discipline. The action does not limit either doctor’s ability to practice medicine. Its primary intent was to create a public record.

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Pseudocyesis is the medical term for a false pregnancy and is considered a psychiatric condition. Pseudocyesis often has all of the signs and symptoms of a real pregnancy, except for the baby. Women can experience cessation of menstruation, weight gain and distended abdomen, tender and swollen breasts, morning sickness, food cravings, and labor pains. Some women also describe the sensation of fetal movement. Many health care professionals can be deceived by the symptoms and may mistakenly diagnose pregnancy when there is no presence of a fetus.

Pseudocyesis is rare, occurring in about one to six for every 22,000 births. The average age of the affected woman is 33, but the condition has even occurred in women as old as 79. More than two-thirds are married and about one third have been pregnant at least once. Women who with fertility problems, those who have suffered a miscarriage or the loss of a child, or those who have been victims of incest may be at greater risk for developing the condition.

There is not one single known cause for pseudocyesis, although it does occur mostly in women with an intense desire to become pregnant. It appears to occur more in cultures that place high value on fertility and pregnancy or where children where are viewed as necessary for economic survival and continuation of generations.

In the United States and other developed countries, the condition occurs less frequently because of easily available techniques to confirm the presence of a baby, such as urine pregnancy tests, blood tests, ultrasounds, and doppler for hearing the baby’s heart beat.

Treatment for women with pseudocyesis includes psychotherapy and possibly medication for depression and anxiety.

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