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What about Vitamin K in cholestasis?
Women with obstetric cholestasis may be offered daily Vitamin K tablets until delivery. This is to minimize the risk of postpartum haemorrhage and also fetal or neonatal haemorrhage. The condition is associated with a theoretical increase in the risk of these complications.
What about the itchy skin eruptions affecting pregnant women?
This is more common than obstetric cholestasis. It can occur at any stage of the pregnancy, even though it is rare in the first fifteen weeks of gestation. Some women are affected for the first time in the first week after delivery.
The characteristic rash normally begins on the abdomen, before spreading elsewhere on the body. The face is usually spared.
The itching can be quite severe and distressing.
Apart from the distress caused by itching, the condition is harmless to the mother and the fetus. When the itching is severe, mild steroids in the form of a cream, lotion, even tablets may be used to relieve the symptoms.
It clears up rapidly and totally after delivery.
Does this condition recur in subsequent pregnancy?
Not always, but it may do. When this happens, it is usually milder than the previous time.
Are there any other pregnancy-specific conditions?
Yes. The one other dramatic skin condition is the one known as "pemphigoid gestationis"(PG) Formerly it was called "herpes gestationis", but the name "herpes" was misleading as it has nothing to do with the herpes virus.
This condition is characterised by the eruption of fluid-filled lesions that then crust. It looks like a water-burn injury, except it itches. The lesions typically start around the navel before spreading all over. Palms and soles are not spared and occasionally the mouth may be affected.
There are no other complications to the mother but the condition has a tendency to recur, with increased severity in subsequent pregnancies.
There is only weak evidence that the baby may be growth restricted in some cases.
A small proportion of babies develop a milder form of the condition after the birth, but this soon clears up.
So, a mother with pemphigoid gestationis (PG) should not worry about the baby’s wellbeing?
Not at all. Even though there is a slight increase in the risk of premature delivery, there is no direct adverse effect on the baby from this condition.
What causes Pemphigoid gestationis (PG)?
This is an autoimmune condition. This means the individual develops antibodies against some normal body proteins. What triggers the development of these hostile antibodies is not known. Whilst the condition is associated with pregnancy, in rare cases the condition can recur after delivery when the periods resume or if the new mother starts taking the oral contraceptive pill.
Pemphigoid gestationis almost invariably resolve completely a few weeks after delivery but rarely symptoms have been known to persist for several months.