Your Pregnancy After 35 : How Your Body Changes during Pregnancy (part 3) - Cholestasis of Pregnancy, Plaques of Pregnancy , Pemphigoid Gestationis

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5. Cholestasis of Pregnancy

A sudden attack of itching on the palms and soles may indicate cholestasis of pregnancy. Itching then spreads to the rest of the body. Cholestasis of pregnancy, also called intrahepatic cholestasis of pregnancy (ICP) or prurigo gravidarum, is a condition in which a woman has severe itching all over the body, but there’s no rash. The condition is rare.

Intense itching all over begins in the third trimester. Usually it’s much worse at night. Treatment includes anti-itch creams and UVB light treatments. Symptoms generally disappear a few days after baby’s birth.

6. Plaques of Pregnancy (PUPP)

Some women have a severe, itchy rash of red bumps that begins on the tummy and spreads to the lower body, then to the arms and legs. This is called plaques of pregnancy, toxemic rash, polymorphic eruption of pregnancy or pruritic urticaria pappules (PUPP). With plaques of pregnancy, your healthcare provider may first rule out scabies.

Maintaining Body Temperature

Your baby relies on you to maintain correct body temperature. An elevated body temperature in a pregnant woman for an extended period may harm a developing fetus. For this reason, avoid hot tubs, saunas, steam rooms and spas. There is some controversy about the safety of using electric blankets/pads during pregnancy. Until we know more, stay warm other ways, such as with down comforters or extra blankets. Or snuggle with your partner. We advise not using an electric blanket or electric warming pad.

PUPP is the most common skin problem pregnant women experience. It may be caused by the skin stretching rapidly, resulting in bumps and inflammation. This condition usually appears in first pregnancies during the third trimester. It often affects women who gain a lot of weight or those who are expecting multiples.

Itching can be so severe that relief may be all you think about, especially at night, which may cause you to lose sleep. PUPP usually resolves within a week after delivery and doesn’t usually come back with future pregnancies.

Many treatments have been recommended for relief; talk to your healthcare provider about them. If you can’t find relief, ask for some recommendations for home remedies that have worked for other women. If all else fails, a prescription for oral antihistamines, topical steroids or cortisone cream may be needed.

7. Pemphigoid Gestationis (PG, Herpes Gestationis)

Pemphigoid gestationis (PG) usually begins with blisters around the belly-button. It may occur in the second or third trimester or immediately after birth. The problem begins with sudden onset of intensely itchy blisters on the tummy in about 50% of cases. For the other 50%, blisters can appear anywhere on the body. It often resolves during the last part of pregnancy. It can flare up at delivery or immediately after baby’s birth, which happens more than 60% of the time.

The goal of treatment is to relieve itching and to limit blister formation. Oatmeal baths, mild creams and steroids are used. PG usually eases a few weeks after delivery and can recur in your next pregnancies and with oral-contraceptive use.

8. Dental Care

See your dentist at least once during pregnancy for a regular dental checkup. Tell your dentist you’re pregnant. If you need dental work, postpone it until after your first trimester, if possible. You may not be able to wait if you have an infection; an untreated infection could be harmful to you and your baby.

If possible, avoid dental X-rays while you’re pregnant. If you must have one, be sure your abdomen and pelvis are completely shielded by a lead apron. Remind the office staff you’re pregnant when you check in.

You may develop small nodules on your gums that bleed when you brush your teeth or eat. This condition is called a pyogenic granuloma or pregnancy tumor. It usually clears up after pregnancy, but don’t ignore it if it causes you problems.

Antibiotics or pain medicine may be necessary if you have dental work. If you need medication, consult your pregnancy healthcare provider before taking anything. Many antibiotics and pain medications are OK to take during pregnancy.

Be careful about anesthesia for dental work during pregnancy. Local anesthesia is OK. Avoid gas and general anesthesia when possible. If general anesthesia is necessary, make sure an experienced anesthesiologist who knows you’re pregnant administers it.

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