Diseases of pregnancy and their management

Abstract

Key Features: Atopic dermatitis is the most common derma-tosis in pregnancy whereas PUPPP is the most common specific dermatosis of pregnancy. Increased levels of serum bile acids is the hallmark of intrahepatic cholestasis of pregnancy; ursodeoxycholic acid is the first-line treatment for moderate to severe cholestasis. Positive direct skin immunofluorescence is the hallmark of herpes (pemphigoid) gestationis; systemic steroids are the first-line treatment for pemphigoid gestationis. PUPPP starts most commonly in the abdominal striae and shows periumbilical sparing associated with multiple gestation pregnancy. Fetal risks in intrahepatic cholestasis include distress, stillbirth, and preterm delivery, and the same in pemphigoid gestationis include small-for-gestational age infants, preterm delivery, and neonatal pemphigoid gestationis. PUPPP, prurigo gestationis, and pruritic folli-culitis of pregnancy present with no maternal or fetal risks, and their etiopathogenesis remains elusive. Skin diseases in pregnancy can be categorized as follows: Preexisting skin diseases affected by pregnancy, the most common being atopic dermatitis. Conditions that cause pruritus but no skin lesions, such as intrahepatic cholestasis of pregnancy. Specific dermatoses of pregnancy. © 2010 Springer-Verlag Berlin Heidelberg.