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Pruritus in Pregnancy

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101. Common Pregnancy Complaints and Questions (Overview)

during pregnancy. The exact mechanism is unclear, but genetic, hormonal, and environmental factors are likely contributory factors. Intrahepatic cholestasis typically occurs in late pregnancy, and it is characterized by intense pruritus and rash over the hands and feet. The maternal prognosis is good, although there may be an increased risk for gallstone disease, hepatic fibrosis, and cholangitis. Fetal consequences are more severe and include meconium ingestion and intrauterine demise. [ ] What hair (...) Common Pregnancy Complaints and Questions (Overview) Common Pregnancy Complaints and Questions: First Trimester, Second Trimester, Third Trimester Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache

2014 eMedicine.com

102. Liver Disease and Pregnancy (Overview)

, and then moves centrally to the trunk and face. The pruritus persists and worsens as the pregnancy continues and resolves within 48 hours of delivery. The pruritus is often worse at night and may be so severe that it causes sleep disturbance, irritability, and psychiatric disturbances. Approximately 10%-25% of patients develop jaundice, usually 1-4 weeks after the onset of pruritus. No rash is associated with ICP. Some patients, however, may have excoriations caused by scratching. Patients may occasionally (...) handling of food. Symptoms Symptoms in pregnancy are the same as those seen in nonpregnant patients, including malaise, fatigue, nausea, vomiting, right upper quadrant pain, and pruritus, which may be more severe in pregnancy (secondary to elevated levels of estrogen). Diagnosis The diagnosis of acute hepatitis A infection is made with the detection of hepatitis A immunoglobulin M (IgM) antibodies. Intrauterine transmission with infection during the first trimester has been reported; this was diagnosed

2014 eMedicine.com

103. Liver Disease and Pregnancy (Treatment)

, and then moves centrally to the trunk and face. The pruritus persists and worsens as the pregnancy continues and resolves within 48 hours of delivery. The pruritus is often worse at night and may be so severe that it causes sleep disturbance, irritability, and psychiatric disturbances. Approximately 10%-25% of patients develop jaundice, usually 1-4 weeks after the onset of pruritus. No rash is associated with ICP. Some patients, however, may have excoriations caused by scratching. Patients may occasionally (...) handling of food. Symptoms Symptoms in pregnancy are the same as those seen in nonpregnant patients, including malaise, fatigue, nausea, vomiting, right upper quadrant pain, and pruritus, which may be more severe in pregnancy (secondary to elevated levels of estrogen). Diagnosis The diagnosis of acute hepatitis A infection is made with the detection of hepatitis A immunoglobulin M (IgM) antibodies. Intrauterine transmission with infection during the first trimester has been reported; this was diagnosed

2014 eMedicine.com

104. Liver Disease and Pregnancy (Follow-up)

, and then moves centrally to the trunk and face. The pruritus persists and worsens as the pregnancy continues and resolves within 48 hours of delivery. The pruritus is often worse at night and may be so severe that it causes sleep disturbance, irritability, and psychiatric disturbances. Approximately 10%-25% of patients develop jaundice, usually 1-4 weeks after the onset of pruritus. No rash is associated with ICP. Some patients, however, may have excoriations caused by scratching. Patients may occasionally (...) handling of food. Symptoms Symptoms in pregnancy are the same as those seen in nonpregnant patients, including malaise, fatigue, nausea, vomiting, right upper quadrant pain, and pruritus, which may be more severe in pregnancy (secondary to elevated levels of estrogen). Diagnosis The diagnosis of acute hepatitis A infection is made with the detection of hepatitis A immunoglobulin M (IgM) antibodies. Intrauterine transmission with infection during the first trimester has been reported; this was diagnosed

2014 eMedicine.com

105. Pruritic Urticarial Papules and Plaques of Pregnancy (Follow-up)

=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTEyMzcyNS10cmVhdG1lbnQ= processing > Polymorphic Eruption of Pregnancy Treatment & Management Updated: May 14, 2018 Author: Joseph C Pierson, MD; Chief Editor: William D James, MD Share Email Print Feedback Close Sections Sections Polymorphic Eruption of Pregnancy Treatment Approach Considerations Treatment is directed at relieving the pruritus associated with polymorphic eruption of pregnancy (PEP). Topical corticosteroids are the mainstay of treatment. [ ] High-potency topical (class I or II), or even systemic (...) Pruritic Urticarial Papules and Plaques of Pregnancy (Follow-up) Polymorphic Eruption of Pregnancy Treatment & Management: Approach Considerations Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache

2014 eMedicine.com

106. Pruritic Urticarial Papules and Plaques of Pregnancy (Diagnosis)

of an unusual skin eruption in pregnancy can provoke anxiety, but the pruritus is the most distressing feature. The later weeks of pregnancy can be associated with many physical symptoms, and the severe itching of PEP may further debilitate and aggravate sleep loss in the weeks prior to delivery. No known systemic complications exist for affected females, and fetal mortality or morbidity do not increase. Previous Next: Patient Education The patient should understand that PEP is a benign disorder and has (...) Pruritic Urticarial Papules and Plaques of Pregnancy (Diagnosis) Polymorphic Eruption of Pregnancy: Background, Epidemiology, Etiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTEyMzcyNS1vdmVydmlldw

2014 eMedicine.com

107. Pregnancy-associated hyperkeratosis of the nipple: a report of 25 cases. (PubMed)

a clinicopathologic analysis of cases of pregnancy-associated nipple hyperkeratosis.Twenty-five cases of pregnancy-associated nipple hyperkeratosis identified during a 5-year period (January 1, 2007, through December 31, 2012) are reported. The lesions were bilateral and involved predominantly the top of the nipple. Lesions were symptomatic in 17 patients (68%), causing tenderness or discomfort, pruritus, sensitivity to touch, and/or discomfort with breastfeeding. Nine patients (36%) experienced symptomatic (...) Pregnancy-associated hyperkeratosis of the nipple: a report of 25 cases. Reported physiologic nipple changes in pregnancy do not include hyperkeratosis and are expected to resolve or improve post partum. Hyperkeratosis of the nipple and/or areola can develop in the context of inflammatory diseases (such as atopic dermatitis), in acanthosis nigricans, as an extension of epidermal nevus, after estrogen treatment, and/or in nevoid hyperkeratosis of the nipple and areola. We performed

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2013 JAMA dermatology (Chicago, Ill.)

108. Il-17 Levels in Intrahepatic Cholestasis of Pregnancy

Il-17 Levels in Intrahepatic Cholestasis of Pregnancy Il-17 Levels in Intrahepatic Cholestasis of Pregnancy - 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. Il-17 Levels in Intrahepatic Cholestasis (...) of Pregnancy 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: NCT01898832 Recruitment Status : Unknown Verified July 2013 by Ayse Kirbas, Zekai Tahir Burak Women's Health Research and Education Hospital. Recruitment status was: Recruiting First Posted : July 12, 2013 Last Update Posted : March 18, 2014 Sponsor

2013 Clinical Trials

109. The Use of Fish Oil Supplementation in Treatment of Intrahepatic Cholestasis of Pregnancy

anticholestatic effects, and is used to treat a variety of cholestatic liver diseases. Many studies have demonstrated superiority of UDCA over other agents, including dexamethasone and cholestyramine, for relief of maternal pruritus, improvement in transaminitis, reduction in serum bile acid concentrations, and improved pregnancy outcomes. As a result, UDCA is now widely used as first-line treatment for symptomatic relief in patients with ICP. Docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are two (...) The Use of Fish Oil Supplementation in Treatment of Intrahepatic Cholestasis of Pregnancy The Use of Fish Oil Supplementation in Treatment of Intrahepatic Cholestasis of Pregnancy - 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

2013 Clinical Trials

110. Reference standard for serum bile acids in pregnancy. (PubMed)

Reference standard for serum bile acids in pregnancy. Obstetric cholestasis (OC) is a liver disorder characterised by pruritus and elevated serum bile acids (SBA) that affects one in 200 pregnant women. It is associated with adverse perinatal outcomes such as premature delivery and stillbirth. Mild OC is defined as SBA levels of 10-39 μmol/l, and severe OC is defined by levels >40 μmol/l. SBA levels in normal pregnancy have not been investigated. We aimed to establish reference values for SBA (...) in healthy pregnant women across different trimesters of pregnancy.Cross-sectional analysis of SBA levels.A large tertiary referral university teaching maternity hospital.Healthy pregnant women with a singleton pregnancy and a body mass index (BMI) < 40, excluding women with significant alcohol intake, history of liver disease, prior cholecystectomy and OC.Cross-sectional analysis of SBA levels at 12, 20, 28 and 36 weeks of gestation, and on days 1-3 postpartum.SBA levels in μmol/l.A total of 219 women

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2012 BJOG

111. Ursodeoxycholic Acid in the Treatment of Intrahepatic Cholestasis of Pregnancy

): Titta Joutsiniemi, Turku University Hospital Study Details Study Description Go to Brief Summary: The purpose of this study is to examine the efficacy and safety of ursodeoxycholic acid (UDCA) in the treatment of patients with intrahepatic cholestasis of pregnancy (ICP). In the randomised (double-blind, placebo-controlled) study 20 pregnant women with ICP received (random allocation of) either 450 mg/day UDCA or placebo for 14 days during the third trimester of pregnancy. The severity of pruritus (...) Ursodeoxycholic Acid in the Treatment of Intrahepatic Cholestasis of Pregnancy Ursodeoxycholic Acid in the Treatment of Intrahepatic Cholestasis of Pregnancy - 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

2012 Clinical Trials

112. Induction of Labor in Intrahepatic Cholestasis of Pregnancy

by Karolinska Institutet: Intrahepatic Cholestasis of Pregnancy Induction of labor Pregnancy Caesarian section Pruritus IUFD Additional relevant MeSH terms: Layout table for MeSH terms Cholestasis Cholestasis, Intrahepatic Pregnancy Complications Bile Duct Diseases Biliary Tract Diseases Digestive System Diseases Liver Diseases (...) Induction of Labor in Intrahepatic Cholestasis of Pregnancy Induction of Labor in Intrahepatic Cholestasis of Pregnancy - 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. Induction of Labor in Intrahepatic

2011 Clinical Trials

113. The Metabolic Profile in Intrahepatic Cholestasis of Pregnancy and Diabetes Mellitus

who have had intrahepatic cholestasis of pregnancy and/or gestational diabetes mellitus matched with parous women who have had uncomplicated pregnancies Criteria Inclusion criteria: Women with intrahepatic cholestasis of pregnancy, defined as pruritus in pregnancy in association with raised serum bile acids and in the absence of an alternative cause. Women with gestational diabetes mellitus (GDM) according to the diagnostic criteria used at the referring centre Non-pregnant parous females (...) The Metabolic Profile in Intrahepatic Cholestasis of Pregnancy and Diabetes Mellitus The Metabolic Profile in Intrahepatic Cholestasis of Pregnancy and Diabetes Mellitus - 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

2011 Clinical Trials

114. Study on Combined Use of Letrozole, Mifepristone and Misoprostol in Termination of Pregnancy

liver and renal function Exclusion Criteria: a history or evidence of adrenal pathology, steroid-dependent cancer, porphyria, diastolic pressure over 95mm Hg, bronchial asthma, arterial hypotension a history or evidence of thrombo-embolism, severe or recurrent liver disease or pruritus of pregnancy the regular use of prescription drugs before admission to the study the presence of an IUCD in utero breast-feeding multiple pregnancies heavy smoker of more than 20 cigarettes per day any abnormal values (...) Study on Combined Use of Letrozole, Mifepristone and Misoprostol in Termination of Pregnancy Study on Combined Use of Letrozole, Mifepristone and Misoprostol in Termination of Pregnancy - 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

2011 Clinical Trials

115. Editorial: Itching in pregnancy. (PubMed)

Editorial: Itching in pregnancy. 1172454 1975 12 11 2018 11 13 0007-1447 3 5984 1975 Sep 13 British medical journal Br Med J Editorial: Itching in pregnancy. 608 eng Journal Article England Br Med J 0372673 0007-1447 AIM IM Cholestasis complications etiology Female Humans Pregnancy Pregnancy Complications Pruritus etiology 1975 9 13 1975 9 13 0 1 1975 9 13 0 0 ppublish 1172454 PMC1674405 Steroids Lipids Res. 1972;3(1):30-48 4679049 Am J Med. 1973 May;54(5):600-4 4735674 Pathol Eur. 1970;5(2

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1975 British medical journal

116. Pregnancy outcomes of women with pruritus, normal bile salts and liver enzymes: a case control study (PubMed)

Pregnancy outcomes of women with pruritus, normal bile salts and liver enzymes: a case control study Obstetric cholestasis (OC) is associated with increased maternal and perinatal complications. Nevertheless, data on pregnancy outcomes of women who experience pruritus on a transient basis, but have normal bile salts and liver function tests (LFT) is scarce.The maternal and fetal outcomes of 144 women with pruritus but normal bile salts and LFTs were compared with the next delivered patient (...) without itch who matched for age, ethnicity and parity.The study and control groups had similar mean gestational ages at delivery and birth weights (p>0.05, t test). However, women with pruritus were more likely to have meconium-stained liqor, abnormal intrapartum cardiotocography and postpartum hemorrhage (PPH) (p<0.05, Fisher's exact test). There appears to be a trend towards a higher rate of instrumental delivery (p=0.07) in the study compared to the control group, although this did not reach

2008 EvidenceUpdates

117. Efficacy of Pregabalin in the Management of Chronic Uremic Pruritus

of >8 weeks duration. Severity of pruritus of 7 or more defined by visual analogue scale. No improvement by oral antihistamines or skin moisturizers. Discontinuation of any medication with presumed antipruritic effects at least 1 week before the study. Negative pregnancy test result for all participating women of childbearing age; Exclusion Criteria: Known allergy to Pregabalin Any acute illness; Liver cirrhosis Active dermatological disorder other than UP Decompensated heart failure; Inability (...) Efficacy of Pregabalin in the Management of Chronic Uremic Pruritus Efficacy of Pregabalin in the Management of Chronic Uremic Pruritus - 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. Efficacy of Pregabalin

2010 Clinical Trials

118. Pruritic Urticarial Papules and Plaques of Pregnancy

. Nonsedating oral antihistamines can also be used to relieve pruritus. Key Points Pruritic urticarial papules and plaques of pregnancy consist of intensely itchy lesions that usually develop during the last 2 to 3 wk of pregnancy and resolve within 15 days after delivery. Differentiating these lesions from others may be difficult. Treat with topical corticosteroids for mild symptoms and oral corticosteroids for more severe symptoms. Last full review/revision October 2017 by Antonette T. Dulay, MD NOTE (...) Pruritic Urticarial Papules and Plaques of Pregnancy Pruritic Urticarial Papules and Plaques of Pregnancy - Gynecology and Obstetrics - MSD Manual Professional Edition Brought to you by The trusted provider of medical information since 1899 SEARCH SEARCH MEDICAL TOPICS Common Health Topics Resources QUIZZES & CASES Quizzes Cases The trusted provider of medical information since 1899 SEARCH SEARCH MEDICAL TOPICS Common Health Topics Resources QUIZZES & CASES Quizzes Cases / / / / IN THIS TOPIC

2013 Merck Manual (19th Edition)

119. Hepatic Disorders in Pregnancy

. Azathioprine and other immunosuppressants, despite fetal risks, are sometimes indicated for severe disease. Intrahepatic cholestasis (pruritus) of pregnancy This relatively common disorder apparently results from idiosyncratic exaggeration of normal bile stasis due to hormonal changes. Incidence varies based on ethnicity and is highest in Bolivia and Chile. Consequences of intrahepatic cholestasis include increased risk of Intense pruritus, the earliest symptom, develops during the 2nd or 3rd trimester (...) types of viral hepatitis (A, B, C, D), but may be more severe during pregnancy. Hepatitis B virus may be transmitted to the neonate immediately after delivery or, less often, to the fetus transplacentally; test all pregnant women for HBsAg to determine whether precautions against vertical transmission are needed. Intrahepatic cholestasis of pregnancy causes intense pruritus and increases risk of fetal prematurity, stillbirth, and respiratory distress syndrome. Fatty liver of pregnancy occurs near

2013 Merck Manual (19th Edition)

120. Acute cystitis

suprapubic pain prior history of urinary tract infections (UTIs) and treatment history recent urinary tract instrumentation flank pain abdominal pain fever vaginal discharge vaginal pruritus dyspareunia structurally or functionally abnormal bladder frequent sexual intercourse history of urinary tract infection (UTI) congenital abnormality spermicidal jelly urinary catheter asymptomatic bacteriuria diabetes spinal cord injuries pregnancy immunodeficiency older age lack of circumcision age <15 years (...) of trimethoprim/sulfamethoxazole or trimethoprim, or 5 days of nitrofurantoin. For complicated cases of cystitis, first line is empirical therapy with a fluoroquinolone antibiotic for 7 to 14 days; treatment should be adjusted based on the results of the urine culture. Complicating characteristics include pregnancy; recent instrumentation, including catheterisation or indwelling catheter; male patient; diabetes, immunosuppression; structurally or functionally abnormal urinary bladder; history of recurrent

2019 BMJ Best Practice

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