The Spectrum of Mucocutaneous Manifestation during Pregnancy: An Observational Study of 170 Pregnant Women Visiting a Tertiary Care Hospital

Abstract

Background: Pregnancy is characterized by myriad of temporary alteration in endocrine, metabolic, and immunological factors. These alterations result in multiple mucocutaneous manifestations. The various skin changes may be either physiological or changes in preexisting skin diseases, or development of new pregnancy-specific dermatoses. Pregnancy-specific skin dermatoses include atopic eruption of pregnancy (AEP), polymorphic eruption of pregnancy, pemphigoid gestationalis, and intrahepatic cholestasis of pregnancy. Aims: The aim of the study was to study the frequency and pattern of mucocutaneous manifestations in pregnant women attending the tertiary care hospital. Settings and Design: A descriptive observational study. Subjects and Methods: A total number of 170 pregnant women attending antenatal outpatient department from October 2017 to March 2019 were included in the study. Detailed history, clinical examination, and relevant investigations were done. Patients not willing to give informed consent were only excluded from the study. Results: In this study, 58.23% (99) were primigravida and 41.77% (71) were multigravida. Most of the cases presented during third trimester (73%). In this study among the 170 pregnant women, the incidence of skin changes observed was 790 physiological entities, nonspecific dermatoses of pregnancy were 95, and 42 cases of specific dermatoses of pregnancy. The most common physiological changes noted were pigmentary changes 46.96% out of all physiological changes. All pregnant women showed pigmentary changes. Most common pigmentary change was linea nigra and melasma. Other changes were striae distensae 14.55%, vascular changes 10.37%, mucous membrane changes 5.19%, pruritus 17%, hair changes 1.51%, and nail changes 1.13%. Tinea corporis was most common infection 48.6% out of all infections, followed by candidal vaginitis 10.8%. Acne vulgaris was most common inflammatory disorder seen in 12.35%, followed by urticaria and psoriasis, seen in 7.05% and 1.76%, respectively. Polymorphic eruption of pregnancy and AEP was seen in 14.70% and 10%, respectively. No cases of intrahepatic cholestasis of pregnancy and pemphigoid gestationalis were noted. Conclusions: This study brings into focus prevalence of various mucocutaneous changes during pregnancy. Thorough knowledge about pregnancy dermatoses is essential to arrive at a specific diagnosis which is a mandate for counseling and management.