Friday, January 13, 2012

Article: Coping with PUPPP and other skin conditions

for Junior Magazine
By. Chiqui Brosas-Hahn*
“I was seven (going eight) months pregnant then. It started with a few itchy wheals on my abdomen. The next thing I know, my body was covered with rashes- from my arms, torso down to my legs. The itch was driving me crazy. The hives was so widespread I would often refuse to go out for fear of people’s reproachful eyes.”- Mommy March
This was how my student in the Bradley method child birth approach recollected her harrowing experience while being pregnant with her first and only son.  Both her OB GYNE and dermatologist were not sure as to what exactly her skin condition was and as to what caused it – one posits that it is an allergy caused by some unknown allergen from the environment or from food that she has eaten and the other simply said that it might be PruriticUrticarial Papules and Plaques of Pregnancy also known as PUPPP with its cause not being definitively known yet.
March is just one of those “lucky” mothers who suffered from a serious skin problem while being pregnant. If you consider dark spots or Chloasma as terrible, or stretch marks, spider and varicose veins as eye sores, by all means count your blessings as some women like March would opt to swap positions with you anytime in a heartbeat.
PUPPP is one of the worst skin conditions a woman can suffer while pregnant. This occurs in 1 out of every 200 pregnancies. The itchy raised bumps usually start at the abdomen which can then spread to the arms, chest, back, legs and feet. This usually occurs in the last trimester of gestation. Although harmless to both the mother and the baby, this can be a cause of concern when the mother gets inadequate sleep (due to itching) which can lead to her losing weight. The rash, however, disappears on its own after a few days from delivery.
 Prurigo of Pregnancy
Also a harmless skin condition that appears as many tiny bumps that look like bug bites. It can be found in all areas of the body. This can appear as early as the first trimester but usually common during the second trimester. This is less common than PUPPP as this can happen only to 1 out of 300 pregnancies.
 Pemphigoid Gestationis
This is the rarest among the severe skin condition a pregnant woman can suffer from as this occurs in 1 out of 7,000 to 50,000 pregnancies. Initially, the itchy patches look like hives but then develop into lesions. The rash usually starts in the belly button and then spreads to the limbs. This condition usually starts in the third trimester and may cause preterm delivery and fetal growth problems. 5% of the babies delivered by mothers suffering from this will also have some noticeable rash when born.
Cholestasis of Pregnancy
This condition can affect 1 out of 50 pregnancies. The main symptom is the intense itching on the palms of the hands and soles of the feet which can spread to the trunk of the body. This usually starts during the third trimester and is caused by some liver impairment. Having this condition will require immediate medical attention as it can cause preterm delivery and other serious problems including fetal demise.
Except the last skin condition, all of the above skin irritations are treatable by anti-itch creams like Benadryl and Calamine lotions.
When asked how she dealt with her own battle of skin problem, March answered that she followed a proactive approach – which means she did not heavily rely on anti-itch creams nor dared try any cortisones or steroids, instead she closely monitored her weight gain and of course the foods she ate. She bought a notebook and pasted a pregnancy weight gain chart on it. She made sure that her weight gain is within the range considering her pre-pregnancy weight. Likewise, she jotted down all the food she ate daily and made sure she ate the prescribed combination of go, grow, and glow foods (fruits, cereals, vegetables, dairies/cereals and meats). She instructed her maid not to put any spices or seasonings, except salt, on her food. (Yes she ate just bland foods for at least 2 months.) Her snacks are mainly fruits or “kakanin.” She stayed away from processed foods and sweets especially chocolates as she realized that eating the latter intensifies the itching afterwards. She also made sure she had sufficient vitamin C intake. When faced with intense itching, she would soak herself in a bathtub for at least 15-30mins with ½ cup of apple cider vinegar combined in the warm water. This relieves the itching and allows her to sleep soundly for at least 2 hours.
 It was a hell of a battle, but with good diet, insurmountable effort of concentration, undying support from her husband and yes after having cried a river especially during the intense bouts of itching, she made it through. She is now a mother to a cute and healthy 6 months old baby boy and she has likewise successfully hurdled the 2008 bar exams despite being pregnant and overly distracted by intense itching during her bar review.
Similar to what she had done, a holistic approach to pregnancy as espoused by the Bradley Method of Child birth is very important. This is because excellent nutrition is always the foundation to a healthy pregnancy and labor. This allows the pregnant mother to embrace her situation and to make sure that she ingests no harmful food that can affect the development of her unborn child. This is a form of early training for the mother and the father in the birthing process and for them to realize that the birth of a child does not entirely start during labor but at the onset of fertilization.
If by any chance you are suffering from any of the above skin conditions while pregnant, seek medical attention promptly. Also, eat healthy and be healthy. Happy birthing!
*Chiqui Brosas-Hahn is a USA Trained Childbirth Educator having attended several ICEA (International Childbirth Education Association) conventions in the USA . She also finished a full course of the Bradley Method as an instructor. She has been teaching childbirth classes for at least eighteen years.  To know more about the Chiqui’s Prepared Childbirth Classes (PCC),

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