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Munchausen syndrome by proxy--a cause of preterm delivery
1Department of Neonatology, Royal Children's Hospital, Parkville, Victoria.
Objective:
To present the first case of Munchausen syndrome by proxy involving self-induced preterm delivery.
Clinical Features:
A 27-year-old Caucasian woman induced antepartum haemorrhage and rupture of membranes with a knitting needle at 26 weeks' gestation, leading to delivery of the infant. This "prenatal child abuse" led to a prolonged intensive care stay, extensive treatment and subsequent bronchopulmonary dysplasia. As the child recovered from the effects of extreme prematurity, he became a victim of fabricated illness and recurrent smothering episodes.
Intervention And Outcome:
After the diagnosis of Munchausen syndrome by proxy was made, the child was removed from the mother and he has since enjoyed good health.
Conclusion:
Self-induction of antepartum haemorrhage can lead to preterm delivery and may be recognisable by certain clinical parameters. The victim of self-induced preterm delivery, if survival ensues, may be subject to further abuse.