Dear Doctor,

I am three months into my pregnancy. Recently, after doing some heavy laundry at home, my body started itching. The next day, my face and feet were swollen. What could be the cause of this and how best can I prevent, treat or manage this condition?

Annette

Dear Anette,

Is this your first pregnancy? If not did you have this problem in previous pregnancies as well? Itching associated with swelling over face and feet, during first trimester can be due to allergy to some substance, either eaten or applied over body or prevailing in the atmosphere. One may be allergic to any cream/lotion or body care product being used. Eczema is said to be aggravated during pregnancy, causing itchy skin with eruptions. One may develop itching due to dryness of skin, as after doing a laundry.

Itching may be due to the effect of high levels of estrogen. During pregnancy, blood flow to the skin is increased, and this can cause mild itching. Intrahepatic Cholestasis is a rare condition affecting one in 100 pregnant women, where deranged liver function develops during pregnancy causing build up of bile salts. This can cause itching.

The condition gets resolved after delivery.

During pregnancy, itching can also be due to fungal or viral infections, as in a non-pregnant state.

Swelling during first trimester can be due to changes in the hormonal balance. Urinary tract infections, passing of albumin in urine, high blood pressure developed during pregnancy, are some other conditions causing swelling.

A cardiac or renal failure may be precipitated during pregnancy causing swelling. In advanced pregnancy, swelling develops over feet due to pressure on the lymphatics and veins of the pelvis by the gravid uterus.

It is advisable to wear loose clothes, particularly those made from cotton, to avoid itching. Drink more water and use suitable moisturising agents to prevent dryness of the skin. Mild itching can be relieved by using anti allergy creams.

If the itching is persistent or becomes severe or eruptions/blisters or severe rashes develop, medical consultation is needed to diagnose and treat the cause. It is also good to get the blood pressure checked. Tests for urinary tract infection, presence of proteins in urine, tests for kidney function and heart failure are useful in excluding a sinister treatable cause for the swelling.

Dr Rachna Pande  is a specialist in internal medicine at Ruhengeri Hospital