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What Causes Itching With Red Spots On Stomach During Pregnancy?

Posted on Wed, 18 Jun 2014

Question: Hello Dr.

The 30th Week [Twin] pregnency and my wife is suffering from itching on her almost complete body and some small red spots on her stomatch are appearing.
plz. let me know the reason and remedy for this.

Thanks,
XXXX

Answered by Dr. Aarti Abraham (19 minutes later)

Brief Answer:
AS BELOW

Detailed Answer:
Hello XXXX
It is nice to hear from you on this platform.
Congratulations for a twin pregnancy !
There can be a few reasons for itching with spots during pregnancy, I would guide you regarding the same .
1. The commonest condition seen is called ICP - Intrahepatic cholestasis of pregnancy. In simpler terms, during pregnancy, due to the effect of hormones, the liver function is not optimum, leading to deposition of bile salts underneath the skin.
THis can lead to rashes and itching.
2. Certain pregnancy specific skin disorders can cause this picture.
3. Allergy or irritation to fabric, talc, moisturizer, soap, detergent etc.
4. Heat related rashes.
Since the itching is generalized, I would think it could be due to ICP - this can be easily confirmed.
Please upload pictures of the spots / rashes if possible, I can have a look and form a better opinion.
Also get her LFT - Liver Function Tests done.
If those are normal, then ICP is virtually ruled out, and other skin conditions can be then thought of and treated.
ICP has a high rate of complications for the baby and mother if not treated, however, if properly treated, it can be managed with ease.
Diagnosis is important, so please get the LFT done at the earliest.
Ask her not to itch the lesions.
She can apply lacto calamine lotion for relief from itching.
I can also guide you regarding more specific treatment once I have the report of the LFT in hand .
All the best
Please feel free to discuss further.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Aarti Abraham (45 hours later)

Hello Dr. XXXXXXX

Thanks a lot for the detailed clarification!!

LFT reprorts are with us and are normal.
Now what next to be done to get rid of itching?

Thanks,
XXXX

Answered by Dr. Aarti Abraham (5 minutes later)

Brief Answer:
AS BELOW

Detailed Answer:
Can you please upload the LFT reports ?
Has she started using Lacto Calamine for the itching ?
Also to regularly moisturize the skin with a good emollient for eg. Palmer's Cocoa Butter.
It will help to prevent stretch marks also.
Once you upload the report I can suggest further medication.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Aarti Abraham (2 hours later)

PF below report:

Healthy liver check:
1. Asperate aminotransferase, serum: 22 15-37 normal
2. alnine aminotransferase, serum: 35 30-65 normal
3. Alkaline Phosphotase, serum : 233, 50-136 normal
4. bilirubin, total, serum : 0.32 0.00-1.00 normal
5. bilirubin, direct, serum : 0.007 0.00-0.30 normal
6. gamma, glutamyl transaferase, serum : 20 5-85 normal
7. lactate , dehydrogenase, serum : 266 81-234 normal
8. total protein , serum : 6.0 6.4-8.2 normal

And no she has not started Lacto Calamine or any other gel/cream for itching.

Answered by Dr. Aarti Abraham (3 hours later)

Brief Answer:
AS BELOW

Detailed Answer:
I wonder why you called these normal as 2 parameters are out of range.
Can you please upload the exact printed report instead of typing out the values ?

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Aarti Abraham (16 hours later)

Hello Dr. XXXXXXX

Our Dr. says even though these two parameters are out of range but are normal in pregnency period.

And sorry to say but dont have provision to scan and upload the report copy here.
I will be looking for alternate option if possible.

Also one more problem :
The milk from my wife's brest was coming in the today morning for some time.

Can you please advise what is wrong , severity and remedy on it.

Thanks,
XXXX

Answered by Dr. Aarti Abraham (1 hour later)

Brief Answer:
AS BELOW

Detailed Answer:
Yes, often in pregnancy, the limits of these parameters can be stretched.
But given the history of itching and these values, it should not be ignored.
You can contact any local computer centre / cybercafe and ask them to scan and upload the report or email it at - YYYY@YYYY
It is quite common in the third trimester for milk secretion to begin.
Specially in twin pregnancies where the hormone levels are higher than average, it can happen.
Nothing needs to be done about it, and there is no cause for worry.
Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Aarti Abraham (26 minutes later)

Thanks a lot Aarti!!

I will be submitting complete report some other time once scan copy is ready with me.

Meanwhile can you suggest the medications for itching?

And on Milk secreation : is it happening beacuse of "MOTHERS horlicks and SHATAWARI" consumption?
She is having MOTHERS horlicks two times a day with MILK" : around 25 gm [includes 2 times]

And in the night before sleep she is having MILK with SHATAWARI [2 teaspoons ]
Please suggest if this is out of requirement?

Thanks,
XXXX

Answered by Dr. Aarti Abraham (2 hours later)

Brief Answer:
AS BELOW

Detailed Answer:
Hi
IN addition to the local ( topical ) applications suggested earlier, I have some oral medications in mind, which I would mention only after looking at the LFT report.
Why is she taking Shatavari, that is to be taken only after delivery, and that too, if the milk supply is less.
That is definitely the reason for the lactation.
Please continue milk with Mother's Horlicks but stop the Shatavari.
Take care.
Will await the report.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar