Cryptic Pregnancy – Symptoms, Causes, and Risks
Medically Reviewed By
Dr. Sabiha Anjum
(Gynecologist/Obstetrician)
This health content has been medically reviewed by qualified experts and follows the FirstCry Parenting editorial policy to ensure accuracy and reliability.
Key Takeaways
- Cryptic pregnancy is a rare condition in which approximately 1 in every 2,500 pregnant women don’t notice they have cryptic pregnancy.
- A cryptic pregnancy is a type of pregnancy in which the individual is unaware of the pregnancy.
- The typical pregnancy symptoms are so mild that they are mistaken for general weakness or gut issues.
- The hCG levels are low in cryptic pregnancy, due to which common pregnancy tests often fail to detect one.
- Lack of knowledge of pregnancy can lead to health and developmental issues for the developing baby.
A cryptic pregnancy is when you are pregnant but don’t know that you are pregnant. Imagine feeling a sudden wave of labour pain, only to learn you have been pregnant all along. The Cleveland Clinic says that in most cases of cryptic pregnancy, women don’t realise they are pregnant until they have labour pains (1). While it may seem unbelievable, cryptic pregnancy is a rare pregnancy occurrence, but it is experienced by about 1 in 475 pregnant women (1) (2). Women whose pregnancies are cryptic have very irregular, mild symptoms of pregnancy that can be easily mistaken for something else or no symptoms at all. In this article, we look at the meaning of cryptic pregnancy, what may cause a cryptic pregnancy, the subtle signs, and the risks of cryptic pregnancy.
What Is a Cryptic Pregnancy?
As per the American Pregnancy Association, a pregnancy is termed ‘cryptic’ or ‘stealth’ when a woman remains unaware of her pregnancy (3). In most of the cases, the pregnancy is discovered late in the pregnancy, around 20 weeks of gestation, during labour pains, or after the birth of the baby (4). In cryptic pregnancy, as the hCG levels are low, the pregnancy goes undetected.
In cryptic pregnancy, the symptoms are very mild or there are no symptoms at all. Add to that, the conventional testing methods also fail to detect the pregnancy. A population study carried out for over 1 year in Berlin reported the occurrence of cryptic pregnancy as 1 in 475 pregnancies at 20 weeks and 1 in about 2500 pregnancies at term (5).
How Common Is a Cryptic Pregnancy?
Cryptic pregnancies are not a common occurrence, with research indicating that approximately 1 in every 475 pregnancies remains undetected until around the 20-week mark of gestation. Furthermore, an even rarer occurrence is observed, where approximately 1 in every 2,500 pregnancies goes unnoticed until the moment of delivery.
What Causes a Cryptic Pregnancy?
Here are some reasons why cryptic pregnancy happens:
1. Polycystic Ovarian Syndrome (PCOS)
Small cysts on the ovaries can cause a hormonal imbalance in women. PCOS creates hormonal imbalances and irregular periods (7).
2. Recent Pregnancy
It’s possible for a woman to get pregnant after a pregnancy. In such a case, skipped periods might be mistaken for postpartum recovery. A woman may fail to realise that she’s pregnant again.
3. Perimenopause
Perimenopause is a condition wherein the female body exhibits symptoms of menopause, such as weight gain and hormonal fluctuations. When women fail to distinguish a pregnancy from perimenopause symptoms, it becomes cryptic.
4. Low Body Fat
For athletes or women with low body fat, hormonal levels may fluctuate, resulting in missed periods. This also makes it harder to detect a pregnancy.
5. Birth Control Pills
Those who use birth control pills and IUDs are usually confident of pregnancy not being a possibility. However, these contraceptive methods don’t guarantee a 100% success rate and can result in pregnancy.
6. Stress
Nowadays, we face a lot of stress due to work or family problems. Stress is one of the major factors of fluctuating hormone levels, especially in women.
What Are the Symptoms of a Cryptic Pregnancy?
In a majority of cases, women are not able to detect the cryptic pregnancy signs as they are usually mild until they experience labour-like symptoms. The American Pregnancy Association lists out some symptoms that you can use to detect a cryptic pregnancy (3):
- Missed period in cases of women who regularly experience irregular periods.
- Occasional spotting that resembles a regular menstrual cycle and is mistaken for a light period (8)
- Nausea and vomiting that is mistaken for other normal health conditions
- Fetal movement in the uterus mistaken for gas or indigestion
- Negative results of urine and blood tests due to fluctuating hormone levels, especially when done very early
- Early labour contractions that feel like period cramping
- No sign of pregnancy in early ultrasounds
- Light baby movements mistaken for a rumbling-like sensation due to gas or upset stomach
How Long Does a Cryptic Pregnancy Last?
The majority of individuals typically become aware of their pregnancy around the 20-week mark. Nevertheless, it is possible for someone to remain oblivious to their pregnancy throughout the entire 40-week duration. Instances have arisen where individuals experiencing pelvic discomfort seek medical attention in an emergency setting, only to realise that they are, in fact, in the midst of labour.
Does a Cryptic Pregnancy Affect Fetal Development?
Since you are unaware of the development of a baby in a cryptic pregnancy, there is a lack of antenatal care, which results in adverse outcomes for the mother and fetus, including preterm birth, poor nutrition for the fetus, pre-eclampsia, small for gestational age babies, or untreated diabetes (6). Lack of prenatal care, such as excessive smoking and drinking, may inadvertently affect the foetus’ health.
Can You Have Bleeding or Continued Periods During a Cryptic Pregnancy?
A cryptic pregnancy is similar to a regular pregnancy, and in cyptic pregnancy as well, you don’t menstruate. So, no periods in a cryptic pregnancy (1). But then what about the bleeding? Well, that could either be implantation bleeding or abnormal pregnancy bleeding, which you may be mistaken as a period.
Can Weight Loss or Weight Gain Occur During a Cryptic Pregnancy?
Skinny cryptic pregnancy or weight gain in cryptic pregnancy is gradual. Weight gain is slower as compared to a woman undergoing a normal pregnancy. Weight loss may occur due to the food aversion that happens in early pregnancy. Since a woman doesn’t know that she’s pregnant, she may not eat a healthy diet.
Can a Cryptic Pregnancy Go Undetected on an Ultrasound?
Many times, a cryptic pregnancy goes undetected even in an ultrasound. Some reasons for this are:
1. Retroversion of the Uterus
Retroversion of the uterus is a condition wherein the uterus tilts either sideways or backwards. If the uterus is in this position, it’s hard for an ultrasound to detect a foetus during early pregnancy.
2. Bicornuate Uterus
A bicornuate uterus is a congenital condition wherein the uterus grows in a heart shape with two horn-like tissues that are divided partially or fully by a wall of tissue. This makes it harder for a woman to conceive and increases the chances of cryptic pregnancy.
3. Scar Tissue
Scar tissue doesn’t allow the ultrasound to get a clear picture of cryptic pregnancy belly, as it blocks the waves of the test. Abnormal scarring may happen due to stomach surgery or incomplete abortion in the past.
Why Do Urine and Blood Tests Be Shown Negative During a Cryptic Pregnancy?
In a normal pregnancy, the result is determined on the basis of the amount of hCG in the blood. hCG is a hormone produced by the placenta during pregnancy. However, in the case of cryptic pregnancy, the uterine lining is regularly removed from the body, not allowing hCG levels to build up. The hCG levels are low in cryptic pregnancy (9). Hence, urine and blood tests cannot detect a pregnancy.
How Do Labour and Delivery Feel With a Cryptic Pregnancy?
Once the baby is fully developed and ready to enter the world, a woman undergoing a cryptic pregnancy feels severe cramps, and her cervix dilates in order to push the baby out through the birth canal. Although labour signs in cryptic pregnancy are similar to those of a normal pregnancy, they can cause psychological distress as well.
What Are the Symptoms of Labour in a Cryptic Pregnancy?
Some labour symptoms associated with cryptic pregnancy are:
- Nausea
- Vomiting
- Chills
- Dizziness
- Body ache
- Mood swings
- Pain in the hips and pelvic region
- Swelling of the vaginal walls due to an increase in blood flow
- Sharp, shooting pain in the breasts
- Pressure on the cervix
What Are the Complications of a Cryptic Pregnancy?
Some complications of cryptic pregnancy include:
- No access to prenatal care
- Complications like hypertension and diabetes
- Foetal harm due to excessive smoking and drinking
How Is a Cryptic Pregnancy Treated?
The way cryptic pregnancy is managed depends on when the individual becomes aware of the pregnancy. If there is still a considerable period left until the expected delivery, a pregnancy care provider will strive to compensate for the missed prenatal care. This all-encompassing strategy could involve various elements, including:
- Blood and urine tests
- Ultrasound
- Measuring fundal height
- A physical exam
- Nutritional and lifestyle counselling
How Can You Prevent a Cryptic Pregnancy?
If you’re married and sexually active, look out for the symptoms of a cryptic pregnancy. If you experience pain or changes in your abdomen or pelvic region, then consult a doctor. If you don’t get your period regularly, inform your gynaecologist about this condition and get yourself checked.
FAQs
1. How long does a cryptic pregnancy last?
The anecdotal evidence suggests that cryptic pregnancies can last longer compared to normal pregnancies, perhaps due to low hormones at the beginning. Most women don’t realise they are pregnant until they are about 20 weeks into pregnancy. There are cases where a woman has gone to the emergency citing pelvic pain, which turned out to be labour pain.
2. How does a baby move in cryptic pregnancy?
Fetal movements within cryptic pregnancies mirror those experienced in regular pregnancies. However, there might be instances where the fetus displays fewer movements due to developmental delays. Often, women might misinterpret these fetal movements as commonplace occurrences like gas or muscle spasms.
3. Are there any emotional and psychological effects of cryptic pregnancy?
Cryptic pregnancy can significantly impact a woman’s emotional and psychological well-being, primarily because it often involves a complete denial of the pregnancy until childbirth. The absence of awareness can result in inadequate neonatal care, potentially contributing to the unfortunate loss of the pregnancy, which in turn intensifies feelings of stress and anxiety.
4. Can I get pregnant without knowing the symptoms of cryptic pregnancy?
Yes, it is easy to miss the signs of cryptic pregnancy as the symptoms are usually mild or atypical, making it difficult to detect the nature of pregnancy.
5. How is a cryptic pregnancy detected?
Attending regular physical exams, like blood tests and ultrasounds, can help detect the case of cryptic pregnancy, especially in cases with hidden or very mild symptoms.
Cryptic pregnancies are hard to detect and affect women physically and psychologically. Knowing all about cryptic pregnancy and keeping your gynaecologist in the loop about your reproductive health is the key to preventing a cryptic pregnancy.
Also Read:
Obese Pregnancy
How Your Face Changes during Pregnancy?
Why Does Your Voice Change in Pregnancy?
Placental Insufficiency – A Pregnancy Complication
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1. Cleveland Clinic – Cryptic Pregnancy
3. American Pregnancy Association – What is a Cryptic Pregnancy?
4. South Australian Perinatal Practice Guideline – Concealed or Denied Pregnancy
5. National Library of Medicine – Cryptic pregnancy
6. National Library of Medicine – Unexpected delivery: cryptic pregnancy
7. Johns Hopkins Medicine – Polyendocrine Metabolic Ovarian Syndrome (PMOS)
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