View source for False pregnancy

{{short description|Signs and symptoms of pregnancy without the presence of a fetus}}
{{about|humans|other mammals|pseudopregnancy}}
{{Use mdy dates|date=August 2020}}
{{Infobox medical condition
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| synonyms        = Phantom pregnancy, hysterical pregnancy, pseudocyesis, delusional pregnancy
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'''False pregnancy''' (or '''pseudocyesis''', {{ety|grc|pseudes|false||kyesis|pregnancy"}})<ref name= Azizi2017/> is the appearance of clinical or [[subclinical]] signs and symptoms associated with [[pregnancy]] although the individual is not physically carrying a [[fetus]].<ref name= Tarin2013/> The mistaken impression that one is pregnant includes signs and symptoms such as tender breasts with secretions, abdominal growth, delayed [[menstruation|menstrual periods]], and subjective feelings of a moving fetus.<ref name= Tarin2013/> [[Physical examination|Examination]], [[ultrasound]], and [[pregnancy test]]s can be used to rule out false pregnancy.<ref name= Azizi2017/>

False pregnancy has a prominent psychiatric component as well as [[Maternal physiological changes in pregnancy|physical manifestations of pregnancy]].<ref name= Tarin2013/> It can be caused by trauma (either physical or mental), a chemical imbalance of hormones,<ref name= Tarin2013/><ref name= Seeman2014/> and some medical conditions.<ref name= Azizi2017/> Contributing psychological factors include a strong desire for pregnancy or misinterpretation of objective bodily sensations.<ref name= Tarin2013/><ref name= Seeman2014/> Although rare,<ref name= Azizi2017/> men can experience false pregnancy symptoms,<ref name= Tarin2013/> called [[Couvade syndrome]] or "sympathetic pregnancy", which can occur when their significant other is pregnant and dealing with pregnancy symptoms.<ref name= Seeman2014/> [[Psychotherapy]], [[pharmacotherapy]] with [[antidepressant]]s or [[antipsychotic]]s, [[hormonal therapy]], and [[Dilation and curettage|uterine curettage]] are sometimes needed as treatment.<ref name= Azizi2017/>

While extremely rare in the United States because of the frequent use of [[medical imaging]], in developing regions such as India and sub-Saharan Africa, the incidence of false pregnancy is higher.<ref name= Tarin2013/><ref name= Seeman2014/> Rural areas see more instances of false pregnancy because such women are less often examined by a health care professional or midwife during the duration of believed pregnancy.<ref name= Tarin2013/>

== Classification ==
In the ''[[Diagnostic and Statistical Manual of Mental Disorders]]'' ([[DSM-5]]), false pregnancy is a [[somatic symptom disorder]]; it is listed as "not elsewhere classified", meaning it is in a category by itself, different from other somatic symptom disorders such as [[functional neurological symptom disorder]] (formerly known as [[conversion disorder]]s).<ref name= Tarin2013/> The word ''pseudocyesis'' comes from the Greek words {{transliteration|grc|pseudes}} which means "false" and {{transliteration|grc|kyesis}} which means "pregnancy".<ref name= Azizi2017/>

False pregnancy is sometimes referred to as "delusional pregnancy", but the distinction between the two conditions is inexact.<ref name= Seeman2014/> Delusional pregnancy is typically used when there are no physical signs of pregnancy, but false pregnancy can also be delusional.<ref name= Bera2015/><ref name= Gogia2020/> Some authors consider the two conditions can be used interchangeably for research purposes.<ref name= Seeman2014/><ref name= Gogia2020/>

== Signs and symptoms ==
The symptoms of pseudocyesis are similar to the symptoms of a true pregnancy.<ref name= Azizi2017/> Signs of false pregnancy include [[amenorrhoea|amenorrhea]] (missed periods), [[galactorrhea]] (flow of milk from breast), breast enlargement, weight gain, abdominal growth, sensations of fetal movement and contractions,<ref name= Azizi2017/> nausea and vomiting,<ref name="Azizi2017" /> changes in the [[uterus]] and [[cervix]],<ref name="Azizi2017" /> and frequent urination.<ref name= Seeman2014/>

Abdominal distention is the most common symptom.<ref name= Tarin2013/> In pseudocyetic abdominal swellings, the abdomen becomes uniformly swollen, and the [[navel]] stays inverted. The wall of the abdomen adopts a muscular, tympanic character.<ref name= Tarin2013/>

Duration of symptoms typically ranges from several weeks to nine months.<ref name= Azizi2017/>

== Causes and mechanism ==
The exact mechanisms behind false pregnancy are not completely understood, but psychological and endocrine components may play a substantial role. Women who experience false pregnancy often experience related feelings of stress, fear, anticipation, and general emotional disturbance.<ref name= Seeman2014/> These strong emotions, along with dysfunctional changes in hormonal regulation, can significantly increase [[prolactin]] levels. Prolactinemia (high prolactin levels) can lead to many of the symptoms of true pregnancy, such as amenorrhea, galactorrhea, and tender breasts.<ref name= Tarin2013>{{cite journal | vauthors = Tarín JJ, Hermenegildo C, García-Pérez MA, Cano A | title = Endocrinology and physiology of pseudocyesis | journal = Reproductive Biology and Endocrinology | volume = 11 | pages = 39 | date = May 2013 | pmid = 23672289 | pmc = 3674939 | doi = 10.1186/1477-7827-11-39 | type = Review | doi-access = free }}</ref><ref name= Seeman2014/> Heightened activity of the [[central nervous system]] may contribute to the [[abdominal distension]], sensations of fetal movement, and assumed [[uterine contraction|contraction]] pains experienced by many women with false pregnancy.<ref name= Tarin2013/>

[[Endocrine system|Endocrine]] changes observed in pseudocyesis include a decrease in [[dopamine]] levels, increase in [[nervous system]] activity, or dysfunction in the [[central nervous system]].<ref name= Azizi2017>{{cite journal | vauthors = Azizi M, Elyasi F | title = Biopsychosocial view to pseudocyesis: A narrative review | journal = International Journal of Reproductive Biomedicine | volume = 15 | issue = 9 | pages = 535–542 | date = September 2017 | pmid = 29662961 | pmc = 5894469 | type = Review }}</ref> These changes may be responsible for [[amenorrhea]], [[galactorrhea]], and [[hyperprolactinemia]] seen in falsely pregnant women.<ref name= Tarin2013/> Elevated sympathetic activity has been linked to the increase in abdominal size as well as the apparent feel of fetal movement and contractions.<ref name=Tarin2013/>

How abdominal distension develops is not fully understood and several causes have been proposed. A buildup in fat around the [[abdominal cavity]], heavy [[constipation]], habitual [[lordosis]], and other causes may produce the appearance of a distended abdomen, and the resulting swelling can remain for months. After women with false pregnancy are placed under [[anesthesia]], or are successfully persuaded that they are not pregnant, the distention promptly disappears, indicating that the proposed mechanisms are supplementary factors behind, but not the ultimate causes of, abdominal swelling.<ref name= Tarin2013/> Manipulation of abdominal wall muscles, such as the [[diaphragm (anatomy)|diaphragm]], is the most likely contributor to abdominal distention. For example, continuously contracting the diaphragm may give the appearance of a distended abdomen while forcing the intestinal units downwards.<ref name= Tarin2013/> The sensations of fetal movement may also be related to contractions of the abdominal wall due to [[peristalsis]], or movements of the [[gastrointestinal tract]].<ref name="Trivedi1998">{{cite journal | vauthors = Trivedi AN, Singh S | title = Pseudocyesis and its modern perspective | journal = The Australian & New Zealand Journal of Obstetrics & Gynaecology | volume = 38 | issue = 4 | pages = 466–8 | date = November 1998 | pmid = 9890236 | doi = 10.1111/j.1479-828X.1998.tb03114.x | s2cid = 39631778 | type = Case reports }}</ref>

About one in six false pregnancies is potentially influenced by concomitant medical or surgical conditions including [[gallstone]]s, abdominal tumors, [[hyperprolactinaemia]], constipation, tubal cysts, and [[esophageal achalasia]].<ref name= Gogia2020/>

[[Psychiatric disorders]], such as [[anxiety]] or [[mood disorders]], [[personality disorders]], and [[schizophrenia]] are common among women with false pregnancy, and may be linked to its development.<ref name= Azizi2017/> Some women with [[Depression (mood)|depression]] may gain weight due to decreased physical activity and poor eating habits.<ref name= Azizi2017/> [[Antipsychotic|Antipsychotics]] can induce pregnancy-like symptoms such as amenorrhea, galactorrhea, breast tenderness, and weight gain via raising prolactin levels.<ref name= Seeman2014/>

=== Risk factors ===
Psychological factors are associated with false pregnancy, including a strong desire for pregnancy; a misunderstanding of sensory changes in the body (for example, bloating or increased pressure on the pelvis); and [[depressive disorder]]s that can lead to changes in the neuroendocrine system.<ref name= Ibekwe2008>{{cite journal | vauthors = Ibekwe PC, Achor JU | title = Psychosocial and cultural aspects of pseudocyesis | journal = Indian Journal of Psychiatry | volume = 50 | issue = 2 | pages = 112–6 | date = April 2008 | pmid = 19742215 | pmc = 2738334 | doi = 10.4103/0019-5545.42398 | type = Case report | doi-access = free }}</ref> Other social factors impacting include low educational status, marital issues, unstable relationship patterns, history of [[domestic abuse|partner abuse]], [[social deprivation]], [[poverty]], lower socioeconomic status, and unemployment.<ref name= Azizi2017/> Other factors such as mental and physical trauma—like experiencing a [[miscarriage]], infertility, loss of child, or sexual abuse—can manifest false pregnancy.<ref name="WhatIs" /> Symptoms may arise in women who are experiencing grief after loss in their reproductive abilities, rejecting the idea of motherhood and pregnancy, or facing challenges in gender identity.<ref name= Azizi2017/> Other psychological factors include [[recurrent miscarriage]]s, stress of imminent [[menopause]], [[tubal ligation]] (sterilization surgery), and [[hysterectomy]].<ref name= Azizi2017/>

== Diagnosis ==
Evaluation required to confirm false pregnancies includes a [[Pelvic examination|pelvic exam]], a blood or urine [[pregnancy test]], and an [[ultrasound]].<ref name="WhatIs">{{Cite web|title=Pseudocyesis: what exactly is a false pregnancy?|date=March 6, 2019 |url=https://americanpregnancy.org/getting-pregnant/pseudocyesis-false-pregnancy/|access-date=July 30, 2020|publisher=American Pregnancy Association}}</ref><ref>{{cite journal |vauthors=Li X, Zhang C, Li Y, Yuan J, Lu Q, Wang Y |title=Predictive values of the ratio of beta-human chorionic gonadotropin for failure of salpingostomy in ectopic pregnancy |journal=Int J Clin Exp Pathol |volume=12 |issue=3 |pages=901–908 |date=2019 |pmid=31933899 |pmc=6945191 }}</ref><ref>{{cite journal |vauthors=Ahmad MF, Abu MA, Chew KT, Sheng KL, Zakaria MA |title=A positive urine pregnancy test (UPT) with adnexal mass; ectopic pregnancy is not the ultimate diagnosis |journal=Horm Mol Biol Clin Investig |volume=34 |issue=2 |date=March 2018 |pmid=29558344 |doi=10.1515/hmbci-2018-0004 |s2cid=4039766 }}</ref> A pelvic exam can show if conception has occurred, blood and urine can be tested for hormones released in pregnancy, and ultrasound shows the absence of the fetus. An ultrasound can accurately distinguish between a false and true pregnancy.<ref name="WhatIs"></ref> There is no universal laboratory profile for women with false pregnancy; measured concentrations for [[prolactin]], [[progesterone]], [[follicle stimulating hormone]], [[estrogen]], and [[luteinizing hormone]] vary widely.<ref name= Trivedi1998/><ref>{{cite journal | vauthors = Starkman MN, Marshall JC, La Ferla J, Kelch RP | s2cid = 2029697 | title = Pseudocyesis: psychologic and neuroendocrine interrelationships | journal = Psychosomatic Medicine | volume = 47 | issue = 1 | pages = 46–57 | date = 1985 | pmid = 3975327 | doi = 10.1097/00006842-198501000-00005 | type = Case reports }}</ref>

In some cases, false pregnancy symptoms may mask underlying medical conditions such as abdominal tumors, central nervous tumors, ovarian cysts, or gallstones. Medical tests and imaging are recommended to rule out potentially life-threatening conditions.<ref name= Gogia2020/>

=== Differential ===
Delusional pregnancy is distinct from false pregnancy; although the distinction is "blurred",<ref name= Seeman2014/> physical signs of pregnancy are not present in delusional pregnancy,<ref name= Campos2016/> while false pregnancy includes symptoms of true pregnancy.<ref name= Bera2015/> According to Gogia ''et al.'' (2020), false pregnancy "involves a false belief that one is pregnant, but differs from delusional pregnancy in that it is a psychosomatic rather than psychotic or purely delusional belief".<ref name= Gogia2020/> In delusional pregnancy, schizophrenia accounts for more than a third of cases.<ref name= Bera2015>{{cite journal |vauthors=Bera SC, Sarkar S |title=Delusion of pregnancy: a systematic review of 84 cases in the literature |journal=Indian J Psychol Med |volume=37 |issue=2 |pages=131–7 |date=2015 |pmid=25969595 |pmc=4418242 |doi=10.4103/0253-7176.155609 |doi-access=free }}</ref>

The symptoms of false pregnancy can be misinterpreted by the individual as a true pregnancy when the symptoms are actually caused by diseases (like hormone-secreting tumors, [[alcoholic liver disease]], [[cholecystitis]], [[urinary tract infection]], [[gallstones]]) or exposure to a substance (like a medication),<ref name= Tarin2013/> or other conditions like constipation.<ref name= Azizi2017/>

== Management ==
Additional interventions such as [[psychotherapy]] and [[pharmacotherapy]] are sometimes needed.<ref name= Azizi2017/> Psychotherapy may be used when individuals have difficulty coming to terms with their false pregnancy, or remain symptomatic after knowing their false diagnosis. It allows patients to confront reality and accept the symptoms as illusions and provides an opportunity resolve other psychological stressors and trauma that may be implicated in manifestations of false pregnancy.<ref>{{cite journal | vauthors = Mortimer A, Banbery J | title = Pseudocyesis preceding psychosis | journal = The British Journal of Psychiatry | volume = 152 | pages = 562–5 | date = April 1988 | issue = 4 | pmid = 3167413 | doi = 10.1192/bjp.152.4.562 | s2cid = 33659629 | type = Case reports }}</ref>

There is no direct evidence for treating false pregnancy with pharmacotherapy, but medications may be used to restore [[hormonal imbalance|hormonal]] and [[neurotransmitter]] imbalances which are implicated in physical manifestations of false pregnancy.<ref name= Azizi2017/> Reduction in [[catecholamine]] levels have been observed in people with symptoms such as hyperprolactinemia and abdominal distentions.<ref name= Tarin2013/> For most people, psychotherapy, pharmacotherapy (with antidepressants or antipsychotics), hormonal therapy, and uterine tissue removal is adequate to treat the condition.<ref name="Azizi2017" />

Antipsychotics have been shown to increase lactation and amenorrhea,<ref>{{cite journal | vauthors = Babu GN, Desai G, Chandra PS | title = Antipsychotics in pregnancy and lactation | journal = Indian Journal of Psychiatry | volume = 57 | issue = Suppl 2 | pages = S303-7 | date = July 2015 | pmid = 26330648 | pmc = 4539875 | doi = 10.4103/0019-5545.161497 | type = Review | doi-access = free }}</ref> and can trigger delusions.<ref name= Gogia2020/> The delusion may be resolved with medication changes or adjustments.<ref name= Gogia2020>{{cite journal |vauthors=Gogia S, Grieb A, Jang A, Gordon MR, Coverdale J|author5-link=John H. Coverdale |title=Medical considerations in delusion of pregnancy: a systematic review |journal=J Psychosom Obstet Gynecol |pages=51–57 |date=June 2020 |volume=43 |issue=1 |pmid=32597281 |doi=10.1080/0167482X.2020.1779696 |s2cid=220254853 }}</ref> When underlying medical conditions or surgical conditions including gallstones, abdominal tumors, hyperprolactinemia, and constipation are identified, treatment may reduce the severity of the delusion.<ref name= Gogia2020/>

== Epidemiology ==
The rate of pseudocyesis in the United States has declined significantly since 1940. The rate in 1940 of one occurrence for approximately every 250 pregnancies had dropped by 2007 to between one and six occurrences for every 22,000 births.<ref name= Azizi2017/> In Nigeria, the frequency of false pregnancies was 1 in 344 true pregnancies, and in Sudan false pregnancies were reported to be 1 in 160.<ref name="Azizi2017" /> There were about 550 cases documented in the literature {{as of|2016|lc=y}}, with most cases in those between the ages of 20 and 44.<ref name= Campos2016>{{cite journal |url= https://www.npjournal.org/article/S1555-4155(16)00222-1/fulltext | journal= The Journal for Nurse Practitioners |volume= 12 |issue= 6 |pages= 390–394 |date= June 1, 2016 |title= Pseudocyesis |vauthors= Campos SJ, Link D |doi= 10.1016/j.nurpra.2016.03.009|doi-access= free |url-access= subscription }}</ref>

Women of reproductive age comprise the majority of pseudocyesis occurrences.<ref name="Seeman2014" /> About 80% of women who experience pseudocyesis are married.<ref name="Seeman2014">{{cite journal | vauthors = Seeman MV | title = Pseudocyesis, delusional pregnancy, and psychosis: The birth of a delusion | journal = World Journal of Clinical Cases | volume = 2 | issue = 8 | pages = 338–44 | date = August 2014 | pmid = 25133144 | pmc = 4133423 | doi = 10.12998/wjcc.v2.i8.338 | type = Review | doi-access = free }}</ref> False pregnancies are more common in societies with certain cultures and religions, particularly in areas where there is a high degree of pressure for women to have multiple children, and for those children [[Female infanticide|to be male]].<ref name= Azizi2017/>

Although rare, pseudocyesis occurs more commonly in [[developing countries]]. It is reported more frequently in countries that place heavy emphasis on fertility and [[childbearing]]; such pronatalist beliefs are often highly prominent in developing countries. In {{clarify span|text=sub-Saharan Africa|reason=Which countries?|date=March 2022}}, a woman is allowed to share her husband's property only if she bears children. In these countries (and other developing nations), infertile women often experience abuse, blame, and discrimination. Societal factors enforce the importance of female fertility in these countries, thus possibly contributing to pseudocyesis rates.<ref name= Seeman2014/>

In addition to men, mothers of pregnant women may experience [[Couvade syndrome]], and a woman can experience multiple episodes of pseudocyesis in her lifetime.<ref name= Thippaiah>{{cite journal | vauthors = Thippaiah SM, George V, Birur B, Pandurangi A | title = A case of concomitant pseudocyesis and Couvade syndrome variant | journal = Psychopharmacology Bulletin | volume = 48 | issue = 3 | pages = 29–32 | date = March 2018 | pmid = 29713103 | pmc = 5875365 | type = Case report }}</ref>

== History ==
The perception of false pregnancy has evolved over time. In the late 17th century, French obstetrician [[François Mauriceau]] believed that the enlarged abdomens of falsely pregnant patients were caused by bad air. Physicians slowly began to acknowledge other potential causes of pseudocyesis, including its origin in the mind and in the body. In 1877, a physician named Joshua Whittington Underhill observed that physical symptoms can convince a woman of pregnancy, or a "disordered brain" can convince her that ordinary abdominal pains or bowel movements are instead fetal movements. The idea that pseudocyesis could result from a woman's perception of herself led to investigation into the role of emotions in cases of pseudocyesis. An investigator in the early 20th century observed that strong emotions can dry a woman's milk supply. The investigator went on to infer that the opposite was also true, and it was believed that strong emotions could bring about its production in women who are not pregnant. Alternatively, some physicians questioned the legitimacy of pseudocyesis as a condition. For instance, French obstetrician Charles Pajot stated in the 19th century, "there are no false pregnancies, only false diagnoses."<ref name= Rutherford1941>{{Cite journal|last=Rutherford|first=Robert N. | name-list-style = vanc |date=April 10, 1941|title=Pseudocyesis|journal=New England Journal of Medicine|volume=224|issue=15|pages=639–644|doi=10.1056/NEJM194104102241505|issn=0028-4793}}</ref><ref name= Daley1946>{{cite journal | vauthors = Daley MD | title = Pseudocyesis | journal = Postgraduate Medical Journal | volume = 22 | issue = 254 | pages = 395–9 | date = December 1946 | pmid = 20287291 | pmc = 2478462 | doi = 10.1136/pgmj.22.254.395 }}</ref>

== Society and culture ==
In the mid-1960s, a woman who appeared to be in labor was not properly examined because delivery appeared imminent; it was thought that her water broke but the expelled liquid was urine.<ref>{{Cite news|last=Svoboda|first=Elizabeth|url=https://www.nytimes.com/2006/12/05/health/05pseud.html|title=All the signs of pregnancy except one: a baby|date=December 5, 2006|work=[[The New York Times]]|access-date=February 16, 2020|language=en-US|issn=0362-4331}}</ref><ref>{{Cite journal|last=Radebaugh|first=John F|date=Spring 2005|title=House calls with John|url=https://dartmed.dartmouth.edu/spring05/pdf/house_calls.pdf|journal=Dartmouth Medicine|pages=48–63}}</ref> In 2010, a woman in the United States who was suspected of being in labor was given a [[Caesarean section|C-section]] but there was no fetus.<ref>{{Cite web|url=https://abcnews.go.com/Health/ReproductiveHealth/pregnant-mother-section-doctors-find-baby/story?id=10262881|title=Doctors perform C-Section and find no baby|website=ABC News|access-date=February 16, 2020 |author= James, Susan Donaldson|date= April 10, 2010}}</ref>

Gynecologist [[Christopher John Dewhurst|John Dewhurst]] studied the sequence of the supposed miscarriages of [[Anne Boleyn]], second wife of [[Henry VIII of England|King Henry VIII of England]], which followed the birth of her first child, [[Elizabeth of England|Elizabeth]], in September 1533 and the series of reported miscarriages that followed. Excluding the miscarriage of a male child of almost four months' gestation in January 1536, he postulated that, instead of a series of miscarriages, Anne was experiencing pseudocyesis (false pregnancies), a condition "occur[ing] in women desperate to prove their fertility.".<ref name=cjd>{{cite journal |last1=Dewhurst |first1=John |author-link1=Christopher John Dewhurst|title=The alleged miscarriages of Catherine of Aragon and Anne Boleyn |journal=Medical History |date=January 1984 |volume=28 |issue=1 |pages=49–56 |doi=10.1017/S0025727300035316|pmid=6387336 |pmc=1139382 }}</ref> Anne's step-daughter [[Mary I of England|Mary Tudor]] had a false pregnancy. After coming to terms with it, she reportedly believed that God had not made her pregnant because she had not sufficiently punished [[Heresy|heretics]].<ref name= Rutherford1941/><ref name= Daley1946/>

[[Anna O.|Anna O]] ([[Josef Breuer]]'s patient as mentioned in 1895 by Breuer and [[Sigmund Freud]] in ''Studies on Hysteria''), experienced false pregnancy in the context of preexisting mental health problems.<ref name=hunter1983>{{cite journal | vauthors = Hunter D | title = Hysteria, psychoanalysis, and feminism: the case of Anna O | journal = Feminist Studies | volume = 9 | issue = 3 | pages = 465–88 | date = 1983 | pmid = 11620548 | doi = 10.2307/3177609 | jstor = 3177609 | url = http://rcin.org.pl/Content/59526| hdl = 2027/spo.0499697.0009.304 | hdl-access = free }}</ref><ref name=charlier2017>{{cite journal |vauthors=Charlier P, Deo S |title=The Anna O. mystery: Hysteria or neuro-tuberculosis? |journal=J. Neurol. Sci. |volume=381 |pages=19 |date=October 2017 |pmid=28991678 |doi=10.1016/j.jns.2017.08.006 |s2cid=39296427 }}</ref> After being diagnosed with [[hysteria]], she believed she was pregnant by Breuer, her therapist. She even believed she was in labor as she was trying to have another session with Breuer.<ref name=hunter1983></ref> More recent publications suggest she had central neurological signs with a chronic cough that improved during high altitude stays. Those characteristics, as well as the ineffectiveness of psychoanalytic cures, seem to indicate a more organic diagnosis such as tuberculous meningitis or tuberculous encephalitis with partial temporal epileptic component.<ref name=charlier2017></ref>

== See also ==
* [[Denial of pregnancy]]
* [[Cryptic pregnancy]]
* [[Murder of Bobbie Jo Stinnett]]

== References ==
{{reflist}}

{{Medical resources
|  DiseasesDB     = 29264 
|  ICD10          = F45.8 
|  ICD9           = {{ICD9|300.11}} 
|  ICDO           =  
|  OMIM           =  
|  MedlinePlus    =  
|  eMedicineSubj  =  
|  eMedicineTopic =  
|  MeshID         = D011555
}}
{{Mental disorders|selected = symptoms}}
{{Pathology of pregnancy, childbirth, and the puerperium}}
{{Authority control}}

[[Category:Health issues in pregnancy]]
[[Category:Human pregnancy]]