Pruritus gravidarum or itching related to pregnancy

What is pregnancy-related pruritus?

Pregnancy pruritus is also called gestational pruritus, pruritus gravidarum or pruritus in pregnancy. It is simply pruritus present during pregnancy.

Pregnancy pruritus can appear at the very beginning of pregnancy or later, usually during the 3rd trimester in cases of polymorphic eruption of pregnancy or obstetric cholestasis. Itching during pregnancy can be a nuisance in everyday life, sometimes even causing insomnia.

The locations of pregnancy itching can vary. Pregnant women often have an itchy stomach, but not exclusively. Pregnancy pruritus can affect the whole body.

The cause of itching is very varied:

• First of all, there are all the "classic" types of pruritus of dermatological origin such as eczema, psoriasis, insect bites, scabies, etc.
• Then, it is important to know that pregnancy leads to changes in the skin that make it drier and more sensitive, hence the appearance of pregnancy pruritus, sometimes from the first months. Having an itchy stomach during pregnancy is also very common because the skin undergoes changes and stretches considerably, especially in this area. In cases of itching on the stomach during pregnancy, remember to apply a hydrating and soothing cream daily.
• Polymorphic Eruption of Pregnancy is a skin condition that appears only during pregnancy, and more specifically at the end of the first pregnancy. It is characterized by red plaques that first appear on the abdomen and are very itchy. Treatment consists of cortisone creams or oral anti-histamines. Polymorphic Eruption of Pregnancy is completely benign for the pregnant woman and her unborn child, and not contagious.
• Finally, some types of pregnancy pruritus are not of dermatological origin but originate from conditions affecting the liver, kidneys, thyroid or blood. This is the case of obstetric cholestasis which is accompanied by itching at the end of pregnancy.

How does obstetric cholestasis occur?

Obstetric cholestasis is the most common liver disease occurring during pregnancy.

In late pregnancy, obstetric cholestasis combines intense pruritus with biological disturbances such as elevated bile acids and liver enzymes called transaminases. Fortunately, these clinical and biological signs of obstetric cholestasis are reversible after delivery. As for pruritus, it first affects the hands and feet but can spread to the rest of the body.

Obstetric cholestasis has no harmful consequences for the mother, except for the pregnancy itching that sometimes prevents her from sleeping. On the other hand, obstetric cholestasis can have harmful consequences for the fetus and this is what makes it so serious. Obstetric cholestasis increases the risk of fetal death in utero, but also of prematurity and respiratory distress at birth. It is therefore essential to go see a doctor in cases of pregnancy pruritus.

How do you relieve obstetric cholestasis?

In case of obstetric cholestasis, the pregnant woman benefits from a close follow-up. The doctor prescribes an oral treatment that will reduce the pregnancy pruritus and improve test results.

At the same time, a few simple rules of hygiene and skincare can help relieve pregnancy pruritus on a daily basis:

• Washing with a superfatted soap, a syndet or a cleansing oil without perfumes or irritating substances.
• Applying an anti-itching cream daily, and reapplying as needed, especially at night.
• Wearing comfortable clothing made of natural, breathable materials such as linen or cotton.