Itching in Pregnancy (See Also Rashes in Pregnancy)

As so often in medicine, the diagnosis, when a patient presents with itching (pruritus) during pregnancy, can frequently be made from taking a history and careful examination. Investigations are rarely required. The differential diagnosis (Table 1) is made up of causes both specific to and unrelated to pregnancy. Table 1 Common causes of itching in pregnancy

Itching related to pregnancy

Itching unrelated to pregnancy

Rashes in pregnancy ^a

Rashes from skin disease

Polymorphic eruption of pregnancy

Atopic eczema

Pemphigoid gestationalis

Eczema (other causes; e.g. contact)

Prurigo of pregnancy

Psoriasis

Pruritic folliculitis of pregnancy

Xerosis (dry skin)

Lichen planus

Pityriasis rosea

Urticaria

Rashes from metabolic changes of pregnancy

Metabolic causes

Hyperthyroidism/hypothyroidism ^b

Hyperthyroidism/hypothyroidism

Cholestasis ^c impairment

Liver disease

Iron deficiency

Renal impairment

Iron deficiency

other causes

Scabies and infestations

Tinea (fungal skin disease)

HIV-related skin disease

Localised itching

Vulval itch ^d

a

See Rashes in pregnancy.

b

See Thyroid problems in pregnancy.

c

See Jaundice and liver disease in pregnancy.

d

See Vulval itching.