PUPPP in Pregnancy: Understanding Symptoms, Causes & Management

Question
Hi my name is stheffanie and im 33 weeks pregnant i have developed a severe case of PUPPP i think you know what im talking about.Im sooo scared cause i have heard women talking about having to be induced because of this condition is this true?

Answer
Dear Stheffanie,

Some information on PUPPP:
Pruritic urticarial papules and plaques of pregnancy (PUPPP) normally occurs in first pregnancies during the third trimester with an average onset of 35 weeks. It usually does not affect subsequent pregnancies.

The actual rash of PUPPP almost always begins in the stretch marks (striae) of the abdomen. It does not involve the belly button, which distinguishes it from other common rashes of pregnancy. The rash itself consists of small, red wheals in the stretch marks that grow together to form larger wheals on the abdomen. Sometimes the rash can include small vesicles. Over the next several days, the rash can spread over the thighs, buttocks, breasts, and arms. The rash is very itchy (pruritic), hence the name, but it is essentially harmless to both mother and baby. It is uncomfortable (!!!), but usually not harmful or associated with any disease process we are aware of.

Occasionally PUPPP is also linked with hypertension. In fact, it can also be known as Toxemic Rash of Pregnancy. There has been an association shown between inductions of labor and PUPPP as well. However, it is important to note that the correlation with hypertension may very well be what leads to the inductions as a safeguard for mother and baby. Otherwise, the treatment for PUPPP is mainly symptomatic.

If you are not seeing in increase in your blood pressures, I would not be concerned about a potential labor induction at this point.

I do apologize for the delay in answering your question. Although we are encouraged to answer within 3-5 days, I usually like to answer my questions within 48 hours. Unfortunately, I am having issues with migraines again and will likely need to take a short LOA from this while I get some medication adjusted. I do hate to make people wait when I know you are anxious for answers, so taking a short leave seems more reasonable. Again, I am sorry for the delay.

I hope this has helped you and answered your question. I wish you well.

Brenda