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SELECTED ARTICLES FROM THE RECENT LITERATURE 2006
12/22/06
Pregnancy outcomes in PUPP
Summary
Background – Pruritic urticarial papules and plaques of pregnancy (PUPPP) is a skin condition occurring in the third trimester in some primigravida women. This intensely pruritic rash starts in and around the stria marks on the lower abdomen spreading to the proximal extremities.
Findings – Ohel et al of Soroka Univ Med Center in Beer Sheva, Israel investigated obstetrical factors and pregnancy outcomes in women with/without PUPPP. PUPPP was present in 42 out of 159,197 (0.03%) of pregnancies. They found that PUPP occurred more commonly in those with multiple pregnancies hypertension, and need for induction of labor (with somewhat lower Apgar scores). However, overall perinatal outcomes were not significantly different in women with vs without PUPPP.
Reference
Matern Fetal Neonatal Med 2006;19:305-8
Editor's Comments
I have reviewed this report because the A/I consultant may be called in to evaluate possible allergic reactions causing what appears to be localized urticaria in a pregnant woman. My understanding from other reports about PUPPP is that this condition generally occurs in primigravida and does not recur with subsequent pregnancies. Yet, multiple pregnancies were a risk factor for PUPPP in the patient group in the study described above (Odds Ratio =4.9).
The etiology of PUPPP is still obscure.
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