#HLWDK Daily Health Tips: Cryptic Pregnancy

Q: Doctor, please discuss cryptic pregnancy

A: There is not much medical literature on cryptic pregnancy, probably because it is an uncommon phenomenon and not really well understood yet. I will provide what information is available and advise anyone who thinks they have this condition to find a good obstetrician for active management and follow up.

A cryptic pregnancy is also known as a denied pregnancy or graviditatas ignota. In this situation, the pregnant woman unconsciously denies the existence of a pregnancy. Please note the word, ‘unconsciously’. Most times, symptoms of pregnancy (nausea, amenorrhea and abdomen swelling) are absent or greatly reduced, babies tend to be underweight and in many cases, pregnancy goes undetected by relatives and doctors

The reasons for cryptic pregnancy are not clear but some associated conditions are as listed below:

  • Peri-menopause – For women who get pregnant around the time of menopause, there may be an absence of many physical symptoms of pregnancy. Just before a woman becomes menopausal, her hormones are ‘all-over-place’. The decreasing levels of estrogen mean that a woman could get pregnant and not know it. Ordinarily, estrogen helps the uterus/womb to grow, maintains the lining of the womb, increases blood circulation, and regulates the production of other key hormones. It is also responsible for those key pregnancy symptoms like spider veins, nausea, increased appetite, and skin changes. Therefore, when you don’t have them, you’re unlikely to think you’re pregnant. This could also happen in early menopause
  • A low level of the hormone Human Chorionic Gonadotrophin (hCG). hCG is the hormone that is sought for when pregnancy tests are conducted. The level of this hormone could be low if the test is done too early in pregnancy. However, some believe that in cryptic pregnancies, the level of hCG is so low that it is not picked up by urine and blood pregnancy tests. As a result, the babies develop at a slower pace. Truth is, a lot of further research is needed to provide evidence for this
  • Irregular menstrual periods may make it difficult for a woman to observe that she is pregnant
  • Other reasons for cryptic pregnancies include inexperience, general lack of attention to body cues (usually, when these women discover they are pregnant, they start recalling incidents that should have alerted them), intense psychological conflicts about the pregnancy especially if pregnancy happens at a time when the woman is not ready (physically, emotionally etc) for a baby and other external stresses

So, I end as I started. This is a rare condition. The women with this condition would not really ‘know’ that they are pregnant and so this is probably more of an incidental finding. If you do suspect that you are pregnant and it is not being picked up, then you should be seeing your obstetrician more regularly and he can advise on other specialties to involve after listening to and examining you.

All the best!

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