Triage Decisions| Volume 42, ISSUE 3, P284-286, May 2016

Cryptic Pregnancies in the Emergency Department

Published:April 08, 2016DOI:
      A woman in Springfield, MA, presents for care, reporting abdominal pain. She states that the pain began several hours ago, and she believes the cause might be a store-bought sandwich she had eaten the night before. When questioned by the triage nurse, she says she has experienced some nausea with vomiting and diarrhea, described as loose to watery. Her medical history, medications, and allergies are unremarkable. The date of her last menstrual period is vague, but she denies being pregnant. She rates her pain as greater than 8 out of 10 and is brought directly to a room. Before the primary nurse can go into the room, the patient begins screaming. Several staff respond, and after a quick assessment, they determine the woman is in labor. The baby’s head is crowning. When asked about her obstetrical history, she acknowledges 2 prior pregnancies, both vaginal deliveries, with 2 healthy children at home. Twenty minutes later, a healthy baby girl is born. The placenta is delivered without incident, and the mother and baby are transferred to the labor and delivery (L&D) unit and nursery department for further management.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Emergency Nursing
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Mohney G
        Massachusetts woman finds out she’s in labor after going to the hospital for abdominal pain.
        (Published November 6, 2015. Accessed March 14, 2016)
        • Del Giudice M
        The evolutionary biology of cryptic pregnancy: a re-appraisal of the “denied pregnancy” phenomenon.
        Med Hypotheses. 2007; 68: 250-258
        • Jick B
        Cryptic pregnancy (“I didn’t know I was pregnant!”).
        (Updated June 2015. Accessed March 14, 2016)
        • Pascual K
        Cryptic pregnancy: why some women do not know they are pregnant and about to give birth.
        (Published November 9, 2015. Accessed March 14, 2016)
        • Stamers K
        • Long N
        Not your average birth: considering the possibility of denied or concealed pregnancy.
        BMJ Case Rep. 2014 May 29; 2014
        • National Partnership for Women and Families
        Best evidence: VBAC or repeat C-section.
        (Updated November 16, 2012. Accessed March 14, 2016)
        • American Pregnancy Association
        Placenta accreta.
        (Updated August 2015. Accessed March 14, 2016)
        • Lim KH
        (Updated February 4, 2016. Accessed March 14, 2016)
        • Emergency Nurses Association
        Obstetrical patients in the emergency department.
        (Updated May 2011. Accessed March 14, 2016)
        • Kattwinkel J
        • Perlman JM
        • Azziz K
        • et al.
        Part 15: neonatal resuscitation: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care.
        Circulation. 2010; 122 ( Accessed March 14, 2016): S909-S919


      Rosalinda S. Hulse is Education Specialist, Emergency Department, Antelope Valley Hospital, Lancaster, CA.


      Heather Ferrell is Staff Nurse, Antelope Valley Hospital, Lancaster, CA.


      Diane Gurney, Member, Central MA Chapter ENA, is Emergency Nursing Education Professional and Consultant, Athol, MA.