What causes severe itching on the body during pregnancy?

Posted on Mon, 16 Apr 2018

Question: My wife is in her 8th month of pregnancy and for the last two weeks she is experiencing itching all across the body. We got LFT test done today and our treating doctor asked us to consult a skin specialist. It would be great if you could recommend the next steps to relive the itching sensation.

Answered by Dr. Kakkar S. (47 minutes later)

Brief Answer:
Symptomatic treatment. Requires monitoring of serum bile acid levels

Detailed Answer:
Hello. thank you for writing to us.

I am asr. kakkar (Dermatologist and Venerelogist). I have noted your concern and I have viewed the attachment.

She has a raised alkaline phosphatase levels (ALP) and raised alanine aminotransferase levels (ALT). Unexplained pruritus in third trimester along with elevated LFTs (particularly ALT and bile acid levels) is suggestive of intrahepatic cholestasis of pregnancy (ICP).
She should be monitored with serum bile acid levels (BA) every 1-2 weeks and if raised above 10 micromol/ litres that would confirm ICP and then she should be treated with udiliv (ursodeoxycholic acid). This is the most specific treatment of ICP.
In the meantime she may be given oral antihistamine which is safe in pregnancy e.g chlorpheniramine (tab. cpm 4mg, thrice daily) for symptomatic relief from itching. Topically she may use a moisturizer to calm itching.

Regards

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