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Obstetric factitious disorder: is it more common than we think?
E A Guthrie1, J M Lavin, A Rosimilia
1Obstetrics and Gynaecology Department, St Mary's Hospital, Manchester.
The British Journal of Clinical Practice
|March 1, 1996
Summary
Factitious disorder during pregnancy requires high suspicion for unexplained bleeding. This case highlights diagnostic challenges and implications for maternal-child care.
Area of Science:
- Obstetrics and Gynecology
- Psychiatry
- Medical Psychology
Background:
- Factitious disorder imposed on self (Munchausen syndrome) is a mental disorder involving the intentional production or feigning of physical or psychological signs or symptoms.
- Pregnancy presents unique challenges for diagnosing factitious disorders due to the complex interplay of physiological changes and potential for medical manipulation.
Observation:
- A 27-year-old pregnant woman presented with recurrent, unexplained vaginal bleeding.
- Initial investigations failed to identify an organic cause for the bleeding, raising suspicion of a factitious disorder.
Findings:
- The diagnostic process involved a multidisciplinary approach, considering psychological factors alongside physical symptoms.
- Evidence suggested the patient was intentionally causing or exaggerating her symptoms to assume the sick role.
Implications:
- This case underscores the critical need for a high index of suspicion in pregnant patients with unexplained symptoms.
- Effective management requires addressing both the medical and psychological aspects of the disorder.
- Consideration of subsequent child care and potential risks is essential following diagnosis.