Complications with all associated notes .pptx

With notes

1. Introduction Peripheral lesions in pregnancy are abnormal growths or changes that occur in the extremities, such as the hands, feet, or legs. These lesions can vary widely in appearance and severity, but they often involve the skin, nails, or underlying tissues.

2. Incidence and prevalence

3. Types of peripheral lesions in pregnancy 1. Skin lesions a) PUPPP (Pruritic Urticarial Papules and Plaques of Pregnancy) Characterized by itchy, red, and hives-like rash that typically appears on the abdomen and can spread to other parts of the body. Management While PUPPP is generally harmless and resolves postpartum Common approaches include. Topical corticosteroids: To reduce inflammation and itching. Antihistamines: To relieve itching.

4. b) Impetigo Herpetiformis Impetigo herpetiformis, also known as generalized pustular psoriasis of pregnancy, is a severe dermatological condition marked by the appearance of numerous pustules on the skin. These pustules are often surrounded by inflamed skin and can be accompanied by systemic symptoms such as fever, chills, and a general feeling of illness. The condition can develop rapidly and is often linked to underlying psoriasis .

5. c) Pemphigoid Gestationis Pemphigoid gestationis , also known as gestational pemphigoid, is a rare autoimmune blistering disorder that occurs during pregnancy. It is characterized by the formation of itchy blisters and urticarial plaques on the skin, predominantly affecting the abdomen but potentially involving other areas. The condition typically presents in the second or third trimester of pregnancy and can resolve spontaneously after delivery, although it can sometimes recur in subsequent pregnancies .

6. Pathophysiology of Pemphigoid gestationis Pemphigoid gestationis is considered an autoimmune condition where the body's immune system mistakenly targets the skin's basement membrane. This membrane, which acts as a glue binding the epidermis to the dermis, becomes compromised, leading to blister formation. The autoimmune response is characterized by the production of antibodies against components of the basement membrane zone.

7. Management of Pemphigoid gestationis Topical Corticosteroids : These are often the first line of treatment to control itching and inflammation. Oral Corticosteroids : For more severe cases, systemic corticosteroids may be necessary. Supportive Care : Ensuring proper hydration and skin care can help manage symptoms and prevent secondary infections .

8. d) Prurigo of pregnancy Prurigo of pregnancy , also known as prurigo gestationis , is a benign and common skin condition that occurs during pregnancy. It is characterized by intensely itchy papules and sometimes vesicles on the skin. Although prurigo of pregnancy is generally harmless and does not have serious implications for the mother or fetus, it can cause significant discomfort.

9. e) Intrahepatic cholestasis of pregnancy Intrahepatic cholestasis of pregnancy (ICP) is a liver disorder unique to pregnancy that typically arises in the third trimester. It is characterized by the accumulation of bile acids in the liver, leading to their release into the bloodstream, which results in severe itching The hallmark of ICP is intense itching, particularly on the palms of the hands and the soles of the feet. The itching may also extend to other parts of the body but is generally without visible rash .

10. Management Management of ICP aims to relieve symptoms and reduce the risk of complications for both mother and fetus Ursodeoxycholic Acid : This medication is the mainstay of treatment. It helps to lower bile acid levels and alleviate itching Monitoring : Regular monitoring of liver function and bile acid levels is essential. Monitoring fetal well-being through non-stress tests or biophysical profiles may also be required.

11. f) Striae gravidarum commonly known as stretch marks, are a common skin condition that affects pregnant women. They appear as reddish or purplish lines on the abdomen, breasts, thighs, and buttocks.

12. 2. Vascular lesions a) Spider Veins (Telangiectasias) Small, dilated blood vessels that can appear on the skin, often due to increased blood volume and hormonal changes .

13. b) Varicose veins Swollen veins, commonly in the legs, which can be exacerbated by the increased blood volume and pressure from the growing uterus. They happen when the uterus applies pressure to the large vein (the inferior vena cava) that carries blood back to the heart from your feet and legs. Varicose veins can become itchy, uncomfortable, or even painful.

14. Complications of peripheral lesions in pregnancy Varicose veins Deep vein thrombosis (DVT). Phlebitis Inflammation of a vein. Impetigo Herpetiformis Sepsis. Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP) : maternal discomfort and itching. Cholestasis of Pregnancy severe itching and may increase the risk of preterm delivery and stillbirth due to the potential impact on liver function and bile acid levels.

15. References Laine, K., & Puhka , M. (2021). Cholestasis of pregnancy and its impact on perinatal outcomes. Journal of Hepatology, 74 (3), 692-700. Liao, J. K., & Lawrence, D. A. (2023). Management of varicose veins during pregnancy: Current perspectives. Vascular Medicine, 28 (1), 42-50. Pochi , P. E., & Dorfman, R. F. (2022). Pregnancy and psoriasis: A comprehensive review. American Journal of Obstetrics and Gynecology, 226 (1), 22-30. Luger, T. A., & Christophers , E. (2019). Pustular psoriasis and related disorders. Dermatologic Clinics, 37 (3), 349-363