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Pruritus in Pregnancy

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1. Effect of plasmapheresis on cholestatic pruritus and autotaxin activity during pregnancy. Full Text available with Trip Pro

Effect of plasmapheresis on cholestatic pruritus and autotaxin activity during pregnancy. 30614557 2019 02 14 1527-3350 2019 Jan 07 Hepatology (Baltimore, Md.) Hepatology Effect of Plasmapheresis on Cholestatic Pruritus and Autotaxin Activity During Pregnancy. 10.1002/hep.30496 Heerkens Marieke M Division of Gastroenterology and Hepatology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands. Dedden Suzanne S Department of Gynaecology, Maastricht

2019 Hepatology

2. Prevalence and Relevance of Pruritus in Pregnancy Full Text available with Trip Pro

Prevalence and Relevance of Pruritus in Pregnancy Pregnant women are at greater risk to suffer from chronic pruritus, but data on this symptom in this group is very limited. The aim of this study was to investigate the prevalence, clinical characteristics, and the importance of pruritus in pregnant women. A total of 292 consecutive pregnant women at the 33.0 ± 6.1 weeks of gestation (WoG) were recruited into this prospective, cross-sectional study. All patients underwent thorough anamnesis (...) and detailed physical examination with the special emphasis on pruritus. Pruritus was assessed according to Visual Analogue Scale (VAS). Quality of life was measured with the Dermatology Life Quality Index (DLQI). The point prevalence of pruritus was 20.2% (n = 59), while pruritus prevalence during the entire pregnancy was 38.0% (n = 111). Pruritus started on average at the 27.2 ± 7.6 WoG; it was significantly more common among women in third trimester. The mean VAS was 4.8 (±2.4) points. The DLQI scoring

2017 BioMed research international

3. Pruritus

: experts in the field from Europe. More than 30% are European Academy of Dermatology and Venereology (EADV) members 3 Abbreviations and explanations AD Atopic dermatitis AEP Atopic eruption of pregnancy CGRP Calcitonin gene-related peptide CKD Chronic kidney disease CNS Central nervous system CNPG Chronic nodular prurigo CP Chronic pruritus (longer than 6 weeks) CPG Chronic prurigo CSU Chronic spontaneous urticaria DIF Direct immunofluorescence ICP Intrahepatic cholestasis of pregnancy IFSI (...) International Forum on the Study of Itch IIF Indirect immunofluorescence IL Interleukin Itch Synonym of pruritus NRS Numerical rating scale NSAID Non-steroidal anti-inflammatory drugs PAR Proteinase-activated receptor PBC Primary biliary cirrhosis PEP Polymorphic eruption of pregnancy PG Pemphigoid gestationis Pruritus A skin sensation that elicits the urge to scratch PUO Pruritus of undetermined origin PTH Parathyroid hormone PV Polycythaemia vera RCT Randomised controlled trials SSRI Selective serotonin

2019 European Dermatology Forum

4. British Association of Dermatologists? guidelines for the investigation and management of generalized pruritus in adults without an underlying dermatosis

variables are that iron overload is asso- ciated with both liver in?ltration 35 (see section 7.7) and Table 2 Causes of generalized pruritus without rash Pruritic skin diseases before rash Disorders of iron metabolism Uraemia Hepatic disease (especially cholestasis) Malignancy Haematological disorders Infection Endocrine disease Neurological disorders Psychological and emotional factors Adverse drug reactions Heart failure Pregnancy Pruritus of elderly skin Pruritus of unknown origin (GPUO) © 2017 (...) Pruritus is a common symptom in patients with various hepa- tobiliary disorders, including cholestasis of pregnancy. 138–140 The skin in hepatic pruritus is often generally hyperpigmented and excoriated. 141 The hands and feet are often the worst- affected areas. 139 Pruritus in association with fatigue at presen- tation may be a marker for more aggressive disease, for exam- ple primary biliary cholangitis. 142 There is a poor correlation between pruritus and bile acid levels, suggesting that other

2018 British Association of Dermatologists

5. Pruritus in Pregnancy

Pruritus in Pregnancy Pruritus in Pregnancy Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Pruritus in Pregnancy Pruritus (...) in Pregnancy Aka: Pruritus in Pregnancy , Pregnancy Related Pruritus , Pruritus gravidarum , Prurigo gravidarum II. Causes See Common, intense involving May spread to thighs, buttocks, s and arms Prurigo of Pregnancy (Common) Onset in second-half of pregnancy s and s over arms and Associated with or (uncommon) Autoimmune disorder with association Occurs in second-half of pregnancy s and bullae form on , extremities (Common) No in mild form (Prurigo gravidarum) Trunk and extremity itching without rash

2018 FP Notebook

6. Total serum bile acids or serum bile acid profile, or both, for the diagnosis of intrahepatic cholestasis of pregnancy. Full Text available with Trip Pro

bile acid profile, composed of primary or secondary, conjugated or non-conjugated bile acids, may provide more specific disease information.To assess and compare, independently or in combination, the diagnostic accuracy of total serum bile acids or serum bile acids profile, or both, for the diagnosis of intrahepatic cholestasis of pregnancy in pregnant women, presenting with pruritus. To define the optimal cut-off values for components of serum bile acid profile; to investigate possible sources (...) ), ProQuest Dissertations & Thesis Database, and Index to Theses in Great Britain and Ireland.Prospective or retrospective diagnostic case-control or cross-sectional studies, irrespective of publication date, format, and language, which evaluated the diagnostic accuracy of total serum bile acids (TSBA) or components of serum bile acid profile for the diagnosis of intrahepatic cholestasis of pregnancy in pregnant women of any age or ethnicity, in any clinical setting, symptomatic for pruritus.We selected

2019 Cochrane

7. Overview of pregnancy complications

Overview of pregnancy complications Overview of pregnancy complications - Summary of relevant conditions | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Overview of pregnancy complications Last reviewed: February 2019 Last updated: September 2018 Introduction Complications in pregnancy can result from conditions that are specifically linked to the pregnant state as well as conditions that commonly arise or occur incidentally in women who are pregnant (...) need for folate. Complications include neural tube defects, spontaneous abortion, and placental abruption. Goh YI, Koren G. Folic acid in pregnancy and fetal outcomes. J Obstet Gynaecol. 2008;28:3-13. http://www.ncbi.nlm.nih.gov/pubmed/18259891?tool=bestpractice.com In pregnant women, iron deficiency anaemia is defined as haemoglobin below 110 g/L (<11 g/dL). Goddard AF, James MW, McIntyre AS, et al; British Society of Gastroenterology. Guidelines for the management of iron deficiency anaemia. Gut

2018 BMJ Best Practice

8. Overview of pregnancy complications

Overview of pregnancy complications Overview of pregnancy complications - Summary of relevant conditions | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Overview of pregnancy complications Last reviewed: February 2019 Last updated: September 2018 Introduction Complications in pregnancy can result from conditions that are specifically linked to the pregnant state as well as conditions that commonly arise or occur incidentally in women who are pregnant (...) need for folate. Complications include neural tube defects, spontaneous abortion, and placental abruption. Goh YI, Koren G. Folic acid in pregnancy and fetal outcomes. J Obstet Gynaecol. 2008;28:3-13. http://www.ncbi.nlm.nih.gov/pubmed/18259891?tool=bestpractice.com In pregnant women, iron deficiency anaemia is defined as haemoglobin below 110 g/L (<11 g/dL). Goddard AF, James MW, McIntyre AS, et al; British Society of Gastroenterology. Guidelines for the management of iron deficiency anaemia. Gut

2018 BMJ Best Practice

9. Cholestasis of pregnancy

disease with bile acid levels >40 micromol/L or severe pruritus remote from term can be treated effectively with ursodeoxycholic acid. Close fetal surveillance with delivery near term can be expected with premature delivery reserved for those with severe, worsening disease despite treatment. Definition Intrahepatic cholestasis of pregnancy (ICP) is a pruritic condition during pregnancy caused by impaired bile flow allowing bile salts to be deposited in the skin and the placenta. The cause (...) -quality evidence found higher incidence of respiratory distress syndrome in neonates delivered of mothers who suffered from intrahepatic cholestasis of pregnancy. Poor quality observational (cohort) studies or methodologically flawed randomized controlled trials (RCTs) of <200 participants. History and exam presence of risk factors pruritus, sparing the face excoriations without rash mild jaundice previous hx of intrahepatic cholestasis of pregnancy (ICP) hx hepatitis C FHx of intrahepatic cholestasis

2017 BMJ Best Practice

10. CRACKCast E177 – Acute Complications of Pregnancy

encephalopathy may also result. Intrahepatic cholestasis of pregnancy typically presents with generalized pruritus and mild jaundice. Nausea and Vomiting in Pregnancy Hyperemesis gravidarum is defined as nausea and vomiting that cause starvation metabolism, weight loss, dehydration, and prolonged ketonemia and ketonuria. Initial management involves rehydration with IV fluids, antiemetics, and demonstration of ability to take oral hydration. Thromboembolism in Pregnancy Thromboembolic disease accounts (...) of sexually transmitted diseases, in general, the tetracyclines and quinolones are contraindicated in pregnant patients. Treatment of genital tract infections may be important for preventing preterm labor and decreasing transmission to the infant. PID is very rare in pregnancy and does not occur after the first trimester. Given the risk of endometrial infection in pregnancy and the need to consider other diagnoses, pregnant patients who have suspected PID require hospitalization and IV antibiotics

2018 CandiEM

11. Prognostic and mechanistic potential of progesterone sulfates in intrahepatic cholestasis of pregnancy and pruritus gravidarum. Full Text available with Trip Pro

pregnancy = 29/100), demonstrating that all three progesterone sulfates are prognostic for ICP. Concentrations of progesterone sulfates were associated with itch severity and, in combination with autotaxin, distinguished pregnant women with itch that would subsequently develop ICP from pruritus gravidarum (group 2: ICP n = 41, pruritus gravidarum n = 14). In a third group of first-trimester samples all progesterone sulfates were significantly elevated in serum from low-risk asymptomatic women who (...) Prognostic and mechanistic potential of progesterone sulfates in intrahepatic cholestasis of pregnancy and pruritus gravidarum. A challenge in obstetrics is to distinguish pathological symptoms from those associated with normal changes of pregnancy, typified by the need to differentiate whether gestational pruritus of the skin is an early symptom of intrahepatic cholestasis of pregnancy (ICP) or due to benign pruritus gravidarum. ICP is characterized by raised serum bile acids and complicated

2015 Hepatology

12. Ursodeoxycholic acid versus placebo in women with intrahepatic cholestasis of pregnancy (PITCHES): a randomised controlled trial. Full Text available with Trip Pro

Ursodeoxycholic acid versus placebo in women with intrahepatic cholestasis of pregnancy (PITCHES): a randomised controlled trial. Intrahepatic cholestasis of pregnancy, characterised by maternal pruritus and increased serum bile acid concentrations, is associated with increased rates of stillbirth, preterm birth, and neonatal unit admission. Ursodeoxycholic acid is widely used as a treatment without an adequate evidence base. We aimed to evaluate whether ursodeoxycholic acid reduces adverse (...) perinatal outcomes in women with intrahepatic cholestasis of pregnancy.We did a double-blind, multicentre, randomised placebo-controlled trial at 33 hospital maternity units in England and Wales. We recruited women with intrahepatic cholestasis of pregnancy, who were aged 18 years or older and with a gestational age between 20 weeks and 40 weeks and 6 days, with a singleton or twin pregnancy and no known lethal fetal anomaly. Participants were randomly assigned 1:1 to ursodeoxycholic acid or placebo

2019 Lancet Controlled trial quality: predicted high

13. Pruritus vulvae

. This can lead to vaginal dryness, itching, burning, and irritation. Pregnancy Increased hormone levels in pregnancy are associated with increased physiological vaginal discharge, and an increased risk of candidal vulvovaginitis, both of which cause vulvular pruritus. This information is based on expert opinion in narrative reviews Overview of vulvar pruritus through the life cycle [ ] and Vulvar dermatoses: a practical approach to evaluation and management [ ]. Gastrointestinal and urinary incontinence (...) changes which cause pruritus vulvae? Manage pruritus vulvae appropriately, depending on the underlying cause: Atrophic vaginitis — see the CKS topic on . Pregnancy — see the CKS topic on . Basis for recommendation Basis for recommendation The evidence to support the management of hormonal changes is discussed within the relevant CKS topic. Gastrointestinal disease and urinary incontinence How should I manage gastrointestinal disease or urinary incontinence which is causing pruritus vulvae? Manage

2017 NICE Clinical Knowledge Summaries

14. Impacts of different methods of conception on the perinatal outcome of intrahepatic cholestasis of pregnancy in twin pregnancies Full Text available with Trip Pro

from 142 twin pregnant women complicated with ICP were retrospectively analyzed, including 51 patients who conceived through IVF-ET (IVF group) and 91 patients with spontaneous conception (SC group). Several biochemical indicators and perinatal outcomes were analyzed. Compared to the SC group, the IVF group had a higher incidence of early-onset ICP (P = 0.015) and more frequent clinical symptoms (P = 0.020), including skin pruritus, skin scratch, and jaundice. Furthermore, the IVF group had higher (...) Impacts of different methods of conception on the perinatal outcome of intrahepatic cholestasis of pregnancy in twin pregnancies Twin pregnancies have a higher prevalence of intrahepatic cholestasis of pregnancy (ICP) than single pregnancies. It is unknown whether in vitro fertilization-embryo transfer (IVF-ET) influences the fetal outcomes in twin pregnancies complicated by ICP. This study aimed to explore the impact of IVF-ET on the perinatal outcomes of ICP in twin pregnancy. Clinical data

2018 Scientific reports

15. Safety, Tolerability and Efficacy of SNA-120 for Treatment of Pruritus and Psoriasis in Subjects Treated With Calcipotriene

Safety, Tolerability and Efficacy of SNA-120 for Treatment of Pruritus and Psoriasis in Subjects Treated With Calcipotriene Safety, Tolerability and Efficacy of SNA-120 for Treatment of Pruritus and Psoriasis in Subjects Treated With Calcipotriene - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached (...) the maximum number of saved studies (100). Please remove one or more studies before adding more. Safety, Tolerability and Efficacy of SNA-120 for Treatment of Pruritus and Psoriasis in Subjects Treated With Calcipotriene The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03448081 Recruitment Status

2018 Clinical Trials

16. Study of the Long Term Safety of Serlopitant for the Treatment of Pruritus (Itch)

Study of the Long Term Safety of Serlopitant for the Treatment of Pruritus (Itch) Study of the Long Term Safety of Serlopitant for the Treatment of Pruritus (Itch) - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding (...) more. Study of the Long Term Safety of Serlopitant for the Treatment of Pruritus (Itch) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03540160 Recruitment Status : Recruiting First Posted : May 30, 2018 Last Update

2018 Clinical Trials

17. Elevated serum alkaline phosphatase · generalized pruritus · Dx? (Abstract)

Elevated serum alkaline phosphatase · generalized pruritus · Dx? A 34-year-old woman was referred to the hepatology clinic for evaluation of an increased serum alkaline phosphatase (ALP) level. She was gravida 5 and in her 38th week of gestation. Her obstetric history was significant for 2 uncomplicated spontaneous term vaginal deliveries resulting in live births and 2 spontaneous abortions. The patient reported generalized pruritus for 2 months prior to the visit. She had no comorbidities (...) and denied any other symptoms. She reported no family history of liver disease or complications during pregnancy in relatives. The patient did not smoke or drink, and had come to our hospital for her prenatal care visits. The physical exam revealed normal vital signs, no jaundice, a gravid uterus, and acanthosis nigricans on the neck and axilla with scattered excoriations on the arms, legs, and abdomen. Her serum ALP level was 1093 U/L (normal: 50-136 U/L). Immediately before this pregnancy, her serum

2018 Journal of Family Practice

18. Study of the Efficacy, Safety and Tolerability of Serlopitant for the Treatment of Pruritus (Itch) With Prurigo Nodularis

Study of the Efficacy, Safety and Tolerability of Serlopitant for the Treatment of Pruritus (Itch) With Prurigo Nodularis Study of the Efficacy, Safety and Tolerability of Serlopitant for the Treatment of Pruritus (Itch) With Prurigo Nodularis - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum (...) number of saved studies (100). Please remove one or more studies before adding more. Study of the Efficacy, Safety and Tolerability of Serlopitant for the Treatment of Pruritus (Itch) With Prurigo Nodularis The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details

2018 Clinical Trials

19. Study Evaluating the Benefit of Music Therapy on Pruritus in Patients With Pruritic Dermatitis

Study Evaluating the Benefit of Music Therapy on Pruritus in Patients With Pruritic Dermatitis Study Evaluating the Benefit of Music Therapy on Pruritus in Patients With Pruritic Dermatitis - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one (...) or more studies before adding more. Study Evaluating the Benefit of Music Therapy on Pruritus in Patients With Pruritic Dermatitis (PRURI-MUSIC) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03701971 Recruitment Status

2018 Clinical Trials

20. Effect of Granisetron on Morphine Induced Pruritus in Cesarean Section

administration of morphine which is considered as a gold standard for analgesia has been associated with a frequent incidence of pruritus and postoperative nausea and vomiting. The incidence of neuraxial opioid induced pruritus varies widely from 30% - 60% after orthopedic surgery with intrathecal morphine injection and from 60% - 100% in pregnant women after neuraxial opioid administration. Parturients appear to be the most susceptible to neuraxial opioid-induced pruritus which probably might be due (...) to granisetron, morphine or amide local anesthetics. Parturients with pruritogenic systemic disease. A coexisting skin disorder or preexisting pregnancy induced pruritus. Parturients with any contraindication for intrathecal anesthesia, e.g. coagulopathy. Emergency cesarean section. Psychiatric disorders. Fetal abnormalities. Failed or unsatisfactory intrathecal block. Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact

2018 Clinical Trials

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