Delusion of Triplet Pregnancy in Abdominal Cavity: A Case Report with a Review of Literature

Abstract

The two terms, pseudocyesis and delusion of pregnancy, were frequently used for pseudopregnancy. Delusion of pregnancy is a special form of hypochondriacal/somatic delusion reported in various psychiatric and organic disorders. The origin of the delusion of pregnancy in schizophrenia has often been explained by psycho-analytic interpretations attributing wish fulfilling, protective role to false beliefs, and mother establishes an undisturbed union with her fetus during pregnancy, which eliminate loneliness and helplessness. The current case is a 49-year-old married female with an illness of total duration of 10 years. Initial symptoms were delusion of infidelity and persecution and 2nd and 3rd person auditory hallucination; however, the patient started reporting around 2 years back that she was pregnant and there were three female children inside her abdominal cavity rather than in uterus. She was firm on this belief and was not convinced by family members even giving evidence contrary to her belief like showing ultrasonography report. She firmly believed that these are gift of God, and they are special children who would be delivered through special procedure. Blood investigation revealed raised prolactin level, blood sugar and ultra sonography suggestive of cholelithisis. Patient's psychiatric symptoms including delusion of pregnancy were significantly improved with treatment, and medical and surgical comorbidities were managed with appropriate consultations.

Delusion of Pregnancy: A Case Report and Literature Review

“…The motivational model interprets delusions as a method of relief from distress and anxiety whereas the deficit model interprets delusion as a product of cognitive dysfunction and abnormalities in perception. 5 The development of delusion of pregnancy occurs in 3 stages. The first stage called “das trema,” is a general stage of apprehension, according to Conrad, and occurs after the loss of a loved one.…”

“…Family therapy and psychoeducation about the condition can ensure the family members cope better with such diagnoses. 5 , 33 …”

“…Family therapy and psychoeducation about the condition can ensure the family members cope better with such diagnoses. 5,33 A huge tally of patients show minimal improvement with the above interventions. Since treatment modalities take different routes, further in-depth exploration and research is necessary to draw a clear distinction between the delusion of pregnancy and pseudocyesis to make sure the patient is better managed.…”

“…As such, the delusion of pregnancy is associated with multiple conditions. 5,15,24 Delusion of pregnancy is applied when there are no obvious physical signs of pregnancy, a distinct feature used to differentiate it from pseudocyesis, a somatic condition of having all signs and symptoms of pregnancy in the absence of a fetus. This condition should also be differentiated from couvade syndrome, pseudopregnancy, and simulated pregnancy.…”

“…Other cases of delusion of pregnancy were reported in women who wanted pregnancy after the loss of their child in women experiencing acute loneliness or in those with ambivalent feelings about pregnancy. 5,15,24 In some cases delusion of pregnancy has been reported in association with other types of delusions such as delusion of infidelity, persecution, and erotomania. 7,24 2 Clinical Medicine Insights: Case Reports believes that she is pregnant and had delivered 15 children in the past 8 years.…”