Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Mar;3(1):25-9.
doi: 10.1258/om.2010.090055. Epub 2010 Mar 4.

Pruritus in pregnancy: a study of anatomical distribution and prevalence in relation to the development of obstetric cholestasis

A P Kenyon  1 , R M Tribe  1 , C Nelson-Piercy  1 , J C Girling  2 , C Williamson  3 , P T Seed  1 , S Vaughan-Jones  4 , A H Shennan  1
Affiliations

Pruritus in pregnancy: a study of anatomical distribution and prevalence in relation to the development of obstetric cholestasis

A P Kenyon et al. Obstet Med. 2010 Mar.

Abstract

The main objective of this study was to determine the prevalence and anatomical distribution of pruritus in 6532 pregnant women from a UK antenatal population. Pregnant women attending and completing antenatal care at two general hospitals over a 12-month period were recruited and contacted on three occasions by post. Medical advice and a questionnaire detailing the nature and severity of their pruritus were included. Pruritus in pregnancy, as reported by questionnaire, affected approximately 23% of pregnancies (n = 1521/6532 women) and 1.6% (n = 25) of these women developed obstetric cholestasis (OC). Overall, 0.66% of the antenatal population (43/6532) had a clinical diagnosis of OC (95% CI: 0.48-0.89%). Itching unrelated to OC was most commonly reported to be worst on the abdomen (31%, 616/2014). Women with OC reported pruritus to be most severe on the palms and soles in 16% (4/25) and 'all over' in 24% (6/25) compared with 5% (54/1120) (P < 0.05) and 4% (42/1120, P < 0.0001) of those without OC. In conclusion, pruritus affected approximately one in four women and OC one in 135 women during the study period. Women whose pruritus is 'all over' or most severe on the 'palms or soles' may be at greater risk of the disease.

Keywords: intrahepatic cholestasis of pregnancy; obstetric cholestasis; polymorphic eruption of pregnancy; prurigo; pruritus; pruritus gravidarum.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Gestation at the onset of pruritus: as recalled by 1521 women completing questionnaires
Figure 2
Figure 2
Anatomical location reported to be the site of most severe pruritus in women with obstetric cholestasis compared with those with pruritus and normal liver function. Black bars represent those women with pruritus. Grey bars represent those with obstetric cholestasis
Figure 3
Figure 3
Diagnoses among women with pruritus who were reviewed by the study team. Two hundred women were referred for review by the study team. The clinical diagnosis concluded as a result of that meeting is shown. PG = pruritus gravidarum; OC = obstetric cholestasis; PPP = pruritus preceding pregnancy; TALFT = transiently abnormal liver function tests
Figure 4
Figure 4
Final diagnoses among women with a pruritic rash. Thirty-nine women with a rash had a dermatological cause for their pruritic rash
See this image and copyright information in PMC

References

    1. Fisk NM, Storey GNB. Fetal outcome in obstetric cholestasis. Br J Obst Gynaecol 1988;95:1137–43 - PubMed
    1. Laatikainen T, Ikonen E. Fetal prognosis in obstetric hepatosis. Ann Chir Gynec Fenniae 1975;64:155–64 - PubMed
    1. Rioseco AJ, Ivankovic MB, Manzur A, et al. Intrahepatic cholestasis of pregnancy – a retrospective case-control study of perinatal outcome. Am J Obstet Gynecol 1994;170:890–5 - PubMed
    1. CESDI Consortium. Study of Antepartum Term Stillbirths. Maternal and Child Health Research Consortium. Confidential Enquiry into Stillbirths and Deaths in Infancy. 5th Annual Report, 1995, pp 41–50
    1. Abedin P, Weaver JB, Eggington E. Intrahepatic cholestasis of pregnancy: prevalence and ethnic distribution. Ethnicity Health 1999;4:35–7 - PubMed

LinkOut - more resources