A case of pregnancy with complications of Munchausen’s syndrome that was difficult to diagnose and treat

Abstract

 A woman in her 20s, gravida 2, para 0, with a medical history of convulsions and loss of consciousness before pregnancy was referred to our department for concomitant consultation with Neuropsychiatry at 10 weeks. At 31 weeks, the patient was found fallen in the waiting room after prenatal check-up. Subsequently, tonic-clonic seizures occurred frequently, and temporary intubation was performed. However, loss of consciousness, dissociation disorder, and seizures still occurred. The patient experienced chronic events, including hematemesis and allergy-like symptoms with antibiotic administration. At Neuropsychiatry, Munchausen syndrome was diagnosed. As judged, continued hospitalization may lead to aggravation of Munchausen syndrome, the patient’s neuropsychiatric disorder was explained only to her family, and she was discharged from the hospital. On the same day, she was discharged because there were no abnormal findings with herself and the fetus. At 39 weeks, labor started, resulting in normal vaginal delivery. After delivery, the patient lost consciousness, but the frequency improved, and she was discharged. Munchausen syndrome is a complicated disorder that is difficult to diagnose. Healthcare professionals must be informed about the disorder for appropriate management.