Munchausen syndrome by proxy--a cause of preterm delivery.
OBJECTIVE
To present the first case of Munchausen syndrome by proxy involving self-induced preterm delivery.


METHODS
A 27-year-old Caucasian woman induced antepartum haemorrhage and rupture of membranes with a knitting needle at 26 weeks' gestation, leading to delivery of the infant. This "prenatal child abuse" led to a prolonged intensive care stay, extensive treatment and subsequent bronchopulmonary dysplasia. As the child recovered from the effects of extreme prematurity, he became a victim of fabricated illness and recurrent smothering episodes.


RESULTS
After the diagnosis of Munchausen syndrome by proxy was made, the child was removed from the mother and he has since enjoyed good health.


CONCLUSIONS
Self-induction of antepartum haemorrhage can lead to preterm delivery and may be recognisable by certain clinical parameters. The victim of self-induced preterm delivery, if survival ensues, may be subject to further abuse.
Goss
P W
PW
Department of Neonatology, Royal Children's Hospital, Parkville, Victoria.
McDougall
P N
PN
D000328:Adult; D001049:Apnea; D002649:Child Abuse; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D009110:Munchausen Syndrome; D016735:Munchausen Syndrome by Proxy; D007752:Obstetric Labor, Premature / Q000209:etiology*; D011247:Pregnancy; D012640:Seizures; D014592:Uterine Hemorrhage / Q000209:etiology