Hello, everyone, I am Sun Yi, and everyone calls me Jojo. I am a master of medicine, an attending doctor of obstetrics and gynecology in Shanghai 3A Hospital, a member of the Popular Science Group of Obstetrics and Gynecology of Shanghai Women’s Rehabilitation Medical Association, and a multi-platform We Media native. I am committed to sharing popular science knowledge on women’s health.
My patient Lily was just 5 months pregnant and began to suffer from skin pruritus. Eczema occurred one after another on her stomach. She uncovered her clothes and grabbed her stomach like a map. It really hurts.
But because her mother-in-law and best friend told her that skin pruritus during pregnancy is normal, so she has not come to the doctor’s office. She is also worried that the doctor’s medication will affect the baby, and plans to endure it.
However, in recent days, it is really itching, fidgeting and unable to sleep at night.
In fact, 30% of women will suffer from skin pruritus or other types of skin diseases during pregnancy. However, we still cannot take it lightly.
Because a small part of skin pruritus is caused by pregnancy complications such as intrahepatic bile stasis, it is not only necessary to relieve itching, but also to treat the etiology, otherwise it may cause fetal intrauterine hypoxia or even death.
Therefore, in case of pruritus and rash, we should first report to the prenatal examination doctor. If the liver and kidney function, blood routine, bile acid and other examination indicators are normal and there is no jaundice, we will only consider skin pruritus during simple pregnancy.
What are the antipruritic methods for skin pruritus during pregnancy?
In principle, external ointment is mainly used. If external application of drugs is ineffective and pruritus is serious, antihistamines can be taken orally to relieve itching.
Jojo will introduce clever ways to deal with this long-standing problem from the aspects of general treatment and drug treatment.
I. General treatment
1. Stress is directly proportional to itching, so pregnant mothers should relax and reduce stress and anxiety.
2. If it is a pregnant mother with allergic constitution, when seasons alternate, such as spring and autumn seasons, it is necessary to reduce going out to avoid allergy caused by contact with pollen.
3. Do a good job of sun protection when going out. Because ultraviolet rays stimulate, eczema and pruritus will also be aggravated. Change personal underwear and underwear frequently, wear cotton underwear, with loose, breathable clothing style as the main, avoid chemical fiber and tights.
4. High temperature and irritating bath products will aggravate itching, so it is forbidden to soak in hot springs and use alkaline soap.
5. Eat reasonably and reduce the intake of irritant ingredients, such as chili, ginger, raw garlic, etc. If mothers are allergic to food, avoid contact with allergens.
2. Drug treatment
1. Recommendation for local medication
External application of calamine lotion, mint phenol, can also choose hormone ointment with less adverse reactions, such as mometasone furoate. Hormone ointment has anti-inflammatory and anti-swelling effects, but it is recommended to use it in a short period of time and cannot be used for a long time.
2. Recommendation of oral drugs
Pregnant mothers with itching all over their bodies, some of which even affect their sleep at night. This group of people can take sedatives or desensitizing drugs, such as estazolam, 1 mg each time and 1-2 times a day for a short time. Intravenous use of calcium gluconate can also relieve symptoms.
Antihistamine drugs, antipruritic effect is very good. Recommended are chlorpheniramine maleate, promethazine, chlorpheniramine. However, diphenhydramine and astemizole are not recommended. Abroad has the use of antailor, 25 ~ 100 mg, 1 ~ 4 times a day.
If the mother has skin allergy, she can inject calcium gluconate or vitamin C and other drugs intramuscularly.
If the skin pruritus is severe and accompanied by scratching and ulceration, pregnant mothers need to add some antibiotics under the guidance of doctors to prevent wound infection.
After the above treatment, most of the pruritus symptoms of pregnant mothers will be significantly improved.
If you are unlucky, it is really skin pruritus caused by ICP (Intrahepatic Cholestasis), then it is necessary to determine the time of termination of pregnancy and the treatment plan according to different types of ICP with different severity, combined with gestational weeks, baby development and presence or absence of intrauterine hypoxia.