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What Causes Itchy Palms And Feet During 35 Weeks Of Pregnancy?

Posted on Wed, 28 Oct 2015

Question: I'm 35 weeks, & for over a month now I've been very itchy in my palms and feet, and just about everywhere else. I have no rash. Just scabs I've got from scratching so much...I keep asking for a bile acid test, and my doctor says there's no need. She pressed down on my upper right side of my stomach and it hurt so bad...she diagnosed me with PUPPS, and I know she's the doctor, but I know it's not PUPPS. How could I have PUPPS with no rash? I suggested being tested for ICP- Intrahepatic Cholestasis of pregnancy. I asked for an order for a bile acid test, and she just laughs at me...I need a second opinion...

Answered by Dr. Ilyas Patel (1 hour later)

Brief Answer:
Most probably Cholestatic pruritus....

Detailed Answer:
Hi,

Welcome to HCM...

You have generalised pruritus without rash...that started before one month and gestational period is 35 weeks. I feel that you may be having Cholestatic pruritus.

Intrahepatic cholestasis affects about 1% of pregnancies. It results in unexplained pruritus (itch) during the second and third tremesters, with raised blood levels of bile acids and/or liver enzymes. You are right...You should go for liver function tests. Kindly discuss with your gynaecologist and have blood tests...serum bile acids and liver enzymes.

For your information I would say that....Intrahepatic cholestasis is associated with some complications like....Increased risk of preterm delivery,Stillbirth (rare),
Increased risk of later hepatobiliary cancer (2–3 times greater than the risk in women in whom pregnancy occurred without intrahepatic cholestasis),
Increased risk of later thyroid disease, diabetes, psoriasis, Crohn disease and cardiovascular disease..etc

For control of Cholestatic pruritus in pregnacy, ursodeoxycholic acid may be considered.

I hope this would help you...

Thanks.

Dr. Ilyas Patel MD

Above answer was peer-reviewed by : Dr. Neel Kudchadkar

Follow up: Dr. Ilyas Patel (2 hours later)

Thank you. I don't understand why there is so much resistance from her to just test me...I'm thinking of just going to L&D to get tested, because I feel as if I ask her again she'll just continue to blow it off as nothing.

Answered by Dr. Ilyas Patel (20 hours later)

Brief Answer:
Most probably Cholestatic pruritus

Detailed Answer:
Hi,

Welcome back...

I can understand your worries. If possible, you may consult some other gynaecologist personally for firm diagnosis of your problem.

Wishing you early recovery..

Thanks..

Dr. Ilyas Patel MD

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Neel Kudchadkar