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A study of pregnancy specific dermatoses and their effect on the outcome of pregnancy

Anju S. Nair, George Kurien, V. G. Binesh

Abstract: Background: Pregnancy being a complex state, the interactions of multiple factors result in a number of cutaneous findings that can be separated into physiologic changes, pre-existing dermatoses that can be aggravated or improved during pregnancy and dermatoses that are specific to pregnancy. Dermatoses specific to pregnancy are important to recognise because they may be pruritic or painful to the mother and may pose significant risk to mother, her fetus or both. Early identification of the condition may go a long way in preventing morbidity and mortality.Methods: Antenatal women attending dermatology outpatient for dermatologic problems or referred from Obstetrics and Gynaecology, department for skin conditions in a tertiary care hospital in Kottayam, Kerala state were taken up for the study. Pregnancy related dermatoses or physiologic changes due to pregnancy if present were noted. The patients were followed up till delivery and the pregnancy outcome recorded. The results were analyzed using SPSS.Results: 94.3% of the patients had physiological changes, hyperpigmentation being the commonest. Specific pregnancy dermatoses were present in 38.3%. 94% of pregnancy dermatoses occurred during third trimester. The most common specific dermatoses observed was pruritic urticarial papules and plaques of pregnancy (PUPPP)-63.6%. It is more common in primi gravida (30/42), in twin pregnancies, in mothers of babies with more birth weight, male babies and those with gestational diabetes mellitus. None of the specific dermatoses produced adverse fetal outcome. Conclusions: Pregnancy dermatoses usually manifest in the third trimester. PUPPP is the commonest pregnancy dermatosis. PUPPP is more common among mothers with increased body weight, gestational diabetes, in twin pregnancy and in mothers with male babies. Most of the common pregnancy dermatoses have no adverse effect on the fetus.
Keywords: Pregnancy Dermatoses / Puppp

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