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DRHC Dubai Gynecology Clinic

Itching in late pregnancy - Dubai Gynaecology Clinic

Cause :


I: Pruritic urticarial papules and plaques of pregnancy

  • It is the most common pruritic dermatosis in pregnancy.
  • The lesions appear after the 34th week of gestation and disappear completely within two weeks after delivery.

Signs and symptoms:

  • It is diagnosed clinically.
  • Red, unexcoriated papules and plaques on the abdomen especially on striae, legs, and arms.

Complications:

PUPPP is not associate with danger on mother or foetus.

Treatment:

  • Antihistamines
  • Topical steroids
  • Antipruritic medication

II: Intrahepatic cholestasis of pregnancy

  • It is characterized by accumulation of bile acids in the liver with subsequent accumulation in the plasma causing pruritus and jaundice after the 30th week of pregnancy.

Clinical findings:

Signs and symptoms:

  • Total body itching focused on palms and soles and sometimes expanding to legs and abdomen without rash.

Laboratory findings:

  • There is increased levels of alkaline phosphatase, bilirubin and serum bile acids.
  • AST and ALT may be mildly elevated.

Complications:

ICP is associated with increase in preterm birth and stillbirth.

Treatment:

  • Ursodeoxycholic acid (UDCA)
  • Antihistamines
  • Delivery at 37-38 weeks

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Dr. Lama Omer

Dr. Lama Omer Sibai

Obstetrics and Gynecology Surgeon

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