Abstract

Aim &Objectives: To study the frequency and pattern of skin changes in pregnancy

Materials & Methods: The material for the study constituted of 100 patients selected from the outpatient antenatal clinic and antenatal ward at NIMRA medical college and Hospital, Vijayawada. All the patients had a complete dermatological examination including the examination of the skin, hair, nails and mucous membranes. All the patients were examined for physiological and pathological changes. All the systems were examined. Vaginal and cervical swabs were taken in patients, who complained of vaginal discharge and pruritus. Routine antenatal investigations were performed such as CBP, CUE, Blood sugar, Blood urea, Serum Creatinine, Blood grouping and typing, HIV&VDRL and HbsAg were done in all patients as a part of anatenatal screening. Liver Function Tests was done for patients who complained of pruritus and who had icterus. Vaginal and cervical swabs were taken in all the patients complaining of vaginal discharge and pruritus of vulvae. These swabs were submitted for direct microscopy and culture for candidiasis, Gram’s staining and microscopy and wet mount examination.

Results: A total number of 100 pregnant women were examined for dermatological changes. Most of the women were multipara and (68) the remaining were primies (32).68% of the women examined were multiparous with 5% having more than 3 pregnancies.15 multipara women in our study belonged to more than 30 years of age group. Pregnancy dermatoses were grouped into : Physiologic changes, Specific dermatoses and dermatoses affected by pregnancy. Pigmentation of the skin was the commonest physiological change seen more in multipara women (100%) than in primies (90.6%). Melasma was more frequent in multipara. Centrofacial type of melasma was the most common form of melasma seen. Striae were more common in the multigravida (79%) than in the primi (65%). Palmar erythema was seen in 8 out of the 100 examined, mostly in primis. The percentage of pregnant women with various affected dermatoses was 21% (21 out of 100). Infections and infestations constituted a major part of affected dermatoses (57%). Second episode of Varicella was seen in 2 out of the 21 dermatoses (9.5%).Both the cases of Varicella were noted in primis. The outcome of both these pregnancies was good.

Conclusions: In our study 12 out of 100 patients had specific dermatoses of pregnancy, of which pruritus gravidarum was the commonest followed by pruritic urticarial papules and plaques of pregnancy. The outcome of pregnancies in women with specific dermatoses of pregnancy and infections in pregnancy was good. There were no fetal anomalies or deaths. Vaginal discharge was observed in 2 out of 100 pregnant women. Only 1 case (50%) was positive for Candida albicans on culture.