Pruritus in pregnancy

Diagnosis of the cause of pruritus in a pregnant patient should be approached systematically, beginning with a detailed history (especially drug exposure) and physical examination. Systemic diseases must be excluded. Liver function tests and hepatitis screen are in order if symptoms suggest liver dysfunction. Stool examination for ova and parasites may be included when there is no skin lesion. Biopsy of an obvious skin lesion or a specific radioimmunoassay may be helpful. A dermatologic consultation is warranted when the diagnosis is in doubt and skin lesions are present. An accurate diagnosis is imperative since certain dermatologic disorders may increase maternal and fetal morbidity and even mortality.