False Pregnancy

One spring day last year, a young woman walked into the clinic of the Boston Lying-in Hospital. She had the "profile," said Dr. Robert Northwall Rutherford, of a woman five months' pregnant. Proudly she told the doctor about the lively kickings of her unborn child, which her husband had also noticed.

Dr. Rutherford gave the patient a careful examination. She was not pregnant. She had no tumor. He wanted to find out what caused the huge swelling, but "she received the diagnosis of spurious pregnancy with contempt," and marched off to consult another physician.

That and similar cases set Dr. Rutherford to scrabbling around in old records, trying to find out something about "pseudocyesis," or false pregnancy. Last week he reported his findings in the New England Journal of Medicine. Excerpts :

> The condition is by no means rare: hundreds of cases have been reported in medical literature. Most famous case: Mary Tudor, Queen of England. In addition to a distended abdomen, a woman may present other signs of pregnancy such as amenorrhea (absence or suppression of menstruation), full breasts, fetal movements, etc. If a doctor is at all suspicious, a biological test, like the Aschheim-Zondek pregnancy test, will solve the problem. But a few doctors have been taken in by the symptoms.

> Most of the women with spurious pregnancy are in their early 30s, are childless, and eager for offspring. They may go from doctor to doctor hoping for encouragement, even prepare baby clothes. Some of them have later gone through a normal pregnancy; in some cases they started in the midst of a spurious pregnancy.

> Many conditions may cause symptoms of pseudocyesis. Sometimes, in older women, an apron of fat develops over the abdomen at menopause. Other women may have large tumors, or their abdomens may be distended with air. Most common cause is hysteria: an intense psychological desire for a child creates a muscular spasm which pushes the abdomen out. Treatment varies : purges may be helpful, or the muscles may be worked into place while the patient is under an anesthetic. Since most of the cases are hysterical, Dr. Rutherford thinks pseudocyesis is psychiatry's baby.

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