A diagnostic and therapeutic approach to pruritus in pregnant women

Pruritus, or itching, is a most uncomfortable affliction and will likely result in a physician visit if it does not resolve quickly. Timely relief is of utmost importance to the patient. The clinician is faced with a diagnostic challenge that begins with determining whether the complaint is localized or more generally distributed. In the pregnant patient, there are potential diagnoses that should be considered early in the course of evaluation as they may affect maternal and fetal health. This approach to the pregnant patient includes a review of the pregnancy-specific and nonpregnancy-related etiologies of pruritus. Emphasis is placed on whether a rash or lesion is present at the onset of itching. Diagnoses are then separated into those specific to and those not specific to pregnancy. A decision tree is provided to facilitate diagnosis, and finally, treatment recommendations and referral suggestions are included.

Duke Scholars

Author Jennifer Occhipinti Howell Obstetrics and Gynecology, Duke Women's Health Associates