Itching During Pregnancy

Frederick R. Jelovsek, MD

Itching during pregnancy is a common symptom. What many women don't realize, however, is that sometimes itching can be a sign of a liver abnormality called intrahepatic (within the liver) cholestasis (pooling of bile salts) of pregnancy. When associated with itching, the skin component is called pruritus gravidarum. It is a rare condition occurring in 1-2/10,000 pregnancies in North America, Asia and Europe. In Chile it occurs in 2% of pregnancies, while in Sweden it has been reported in up to 14% of pregnant women. It is more common in the last 3 months of pregnancy and with twin pregnancies. It recurs in subsequent pregnancies in 60-70% of women. About half the time it is associated with yellow jaundice. The stillbirth rate and rate of neonatal death associated with fetal distress is increased about 3-4 times.

When a rash, not just that from scratching, is present, the main differentiating factor is whether a fever is present. If it is, it can represent chicken pox (varicella), Fifths disease (parovirus) or even a reaction to some drug or medication you are taking. If no fever is present your doctor will need to decide if it is a pregnancy specific skin problem or something that is just coincidental with pregnancy such as eczema, psoriasis or scabies for example. There are some pregnancy specific skin diseases that are quite dramatic but disappear completely after delivery.