rash in pregnancy

Question 1

differential for rash in pregnancy

Answer 1

• contact/allergic dermatitis
• medical (i.e. lupus)
• pruritic urticarial papules and plaques of pregnancy (PUPPS)
• parvovirus
• pemphigus gestationalis

Question 2

treatment for pupps

Answer 2

topical application - oatmeal baths

if needed steroid taper vs low dose prednisone PO (5-10 mg daily)

Question 3

icp diagnosis

Answer 3

bile acid > 10 with clinical picture (pruritis without rash, 20% have jaundice, 50% have dark stools or urine)

Question 4

risks of icp

Answer 4

if bile acids > 40 (so check again at 35 weeks), increased risk of PTD, IUFD, fetal heart abnormalities

Question 5

delivery timing

Answer 5

if very elevated (100+): delivery 36-37 weeks
if elevated (40+): delivery 37-38 wks
if elevated (10+): delivery 38-39w6d