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Pregnant and Clueless...Really?

On the Today Show, I watched a story about a woman who, after a 9-mile training run for a half marathon, is taken to the hospital with horrible stomach pains only to give birth to a baby girl. Can someone be pregnant at full term and not know it? Strange but actually true, it is called unknown concealed pregnancy.

Statistics show the chances of not knowing you are pregnant at 20 weeks gestation is about 1 in 457 pregnancies. However, the chances of not knowing you are pregnant at full term and in labor are about 1 in 2,455 pregnancies. And actually, this is still more likely than having triplets, which occurs about 1 in 7,225 pregnancies.

This condition is also called denied pregnancy, which often has a psychiatric component. It is very common in young girls who have conflicts and stress over being pregnant such as fear of anger and relationship problems with their parents, repressed sexuality and religious prohibition to sexual activity.

Risk Factors for this denied pregnancy cited in medical literature are individuals who tend to be younger adolescents, those with intellectual limitations or social isolation, women who have problems with substance abuse and those who have irregular menses or might be obese. However there are always exceptions to all these risk factors.

Some women can have bleeding or spotting during their denied pregnancy which makes this condition seem more plausible. Bleeding during pregnancy can be inconsequential or it can be an indication of serious problems with the pregnancy, depending on the amount of bleeding and any associated abdominal pain. Bleeding during pregnancy can be a sign of life threatening medical problems such as miscarriage, ectopic pregnancy (pregnancy not in the uterus), placenta previa (separation of placenta early on in labor), or abruption placenta (traumatic separation of the placenta.)

All of these pregnancy emergencies can lead to both the mother’s and/or baby’s death.

That is why practically every women of childbearing age who comes to the ER with belly pain and or vaginal bleeding should be checked for pregnancy! As an ER doc I have seen it myself with a young girl of 13 whose mom brought her into the ER with a stomach ache, which turned out to be labor pains! Neither said they had any clue she could be pregnant.

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© Dr. Leigh Vinocur, 2022.
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