"Covard's" Syndrome? Anyone know?

[BabyRN2Be]

A few days ago I was talking with someone else who had worked in L&D for 10+ years. We got to talking about all the "hospital underground" information and we got to talking about people who show up in L&D triage looking 9 months pregnant, however, on exam, there's no baby in there! The woman will say, "I've missed my period, I've got all the symptoms, I'm growing and I feel it moving!" My friend says it's called something like "Covard's Syndrome." Does anyone know what the real name is?

At the hospital where I work at, if someone presents with this, they get their picture taken, they are named a security risk at the hospital, and end up with a psych consult and maybe some time in the psych unit.

Has anyone heard of this syndrome or have experience with this?

[llg, PhD, RN]

There is a French word ... usually used to refer to a husband who experiences some of the symptoms of pregnancy -- not to a "hysterical pregnancy" as you have described. I am terrible speller and haven't looked it up, but it is something "Couvade Syndrome."

llg

[talaxandra]

False or pseudopregnancy is also known as pseudocyesis. It is usually psychosomatic but may be caused by a tumour or endocrine dysfunction, in which physical symptoms of pregnancy are manifested without conception. It occurs most frequently in women, but man can also present with the condition. It also occurs in (female) animals, most often dogs but also in goats and cats.

"Where there is no physiological cause, it usually results from a strong desire or need for motherhood; menstrual periods cease, the abdomen becomes enlarged, and the breasts swell, sometimes even secreting milk. The uterus and cervix may show signs of pregnancy, urine tests may be falsely positive, and the woman may report sensations of fetal movements. A woman may believe in her pregnancy to the point of delusion and show acute depression when no baby is born.

"It has been suggested that depression can sometimes alter the activity of the pituitary gland so as to cause hormone level changes that mimic the hormone changes of real pregnancy." http://www.answers.com/topic/pseudocyesis?hl=false&hl=pregnancy

Cotard's syndrome or delusion is a psychiatric spectrum disorder which "comprises any one of a series of delusions ranging from the fixed and unshakable belief that one has lost organs, blood, or body parts to believing that one has lost one's soul or is dead. In its most profound form, the delusion takes the form of a professed belief that one does not exist.

"Encountered primarily in psychoses such as schizophrenia and bipolar disorder, Cotard's syndrome has also been described in organic lesions of the nondominant temporoparietal cortex as well as in migraine. Cotard's delusion is the only self-certifiable syndrome of delusional psychosis." http://www.jefallbright.net/node/1729

In either case I can see why psychiatric intervention could be required, but the whole security threat thing seems unnecessary and unwarranted.

[USA987, MSN, RN, NP]

I experienced a pt. with this while I was in nursing school. It was very interesting... The human body is truly an amazing thing.

[talaxandra]

There is a French word ... usually used to refer to a husband who experiences some of the symptoms of pregnancy -- not to a "hysterical pregnancy" as you have described. I am terrible speller and haven't looked it up, but it is something "Couvade Syndrome."llg

Couvade syndrome, widely reported in the form of case reports, is a poorly understood phenomenon in which the expectant father experiences somatic symptoms of pregnancy. The commonly reported symptoms include indigestion, increased or decreased appetite, weight gain, diarrhea or constipation, headache, and toothache. Onset is usually during the third gestational month. Symptoms generally resolve with childbirth. Although the exact cause is not known, couvade syndrome is seen as a somatic expression of anxiety, pseudo-sibling rivalry, identification with the fetus, ambivalence about fatherhood, statement of paternity, or parturition envy. Explanations also include cultural pressure, intrapsychic processes, and psychosocial adaptation to the new situation. http://www.rednova.com/news/health/124498/couvade_syndrome_equivalent/

The article goes on to describe a case where the patient wasn't (as is typical) the pregnant woman's partner, but her sister. Very interesting (and making me wonder if my back ache is sympathy pains for my pregnant sister :)

[BabyRN2Be]

Thanks talaxandra for the information. I've heard of this syndrome in dogs, in fact we had one who had a false pregnancy. She was just a puppy so maybe she was just going into heat for the first time. We had her fixed, so that's not a problem anymore.

Back to the subject.

The hospital views her as a security threat because the desire is so strong to have a child that she may make her way onto the OB floor and attempt to kidnap a newborn. I believe that the security risk is more prevalent to the OB side of the hospital rather than the "mainstream." Our OB dept is housed in the women's center and is sort of "freestanding" from the main hospital. Her pic would be distributed to security for the women's center as a precaution.

No telling what people might do to get a newborn.

This is sort of OT, but the other day I was present when an adoptive mom got to take her baby home. She was just so excited, and I was so excited and happy for her. It's really neat to be there for an event like that. :)

[talaxandra]

I didn't think of that at all, maybe because we don't have any mid/paeds department. Okay, that makes complete sense, then, and is wholly reasonable :) Poor women.

i'm glad you got to share in that new mum's happiness :)

Apparently, even spayed dogs can have false pregnancies, which is really interesting. On the other hand, if men can have symptoms... the mind is an amazing thing.