Spectrum of Dermatological Disorders in Pregnancy: Insights From a Tertiary Health Care Centre

Objective: To evaluate the effects of dermatological disorders during pregnancy on maternal and fetal health. Material and Methods: A prospective observational descriptive study was conducted in outpatient and inpatient department of Obstetrics and Gynaecology in collaboration with department of Dermatology, Venereology and Leprology, Pt. B. D. Sharma PGIMS Rohtak after obtaining approval from Scientific Research and Ethics Committee. Patients with physiological skin changes during pregnancy were excluded. Eighty pregnant women presenting with new-onset or exacerbated dermatological conditions were enrolled. A comprehensive clinical evaluation, diagnostic investigations, and follow-up were performed. Data was analyzed statistically. Results: Out of 80 pregnant women enrolled, 48 (60%) had pregnancy-specific dermatoses, 21 (26.3%) had infectious dermatoses, and 11 (13.7%) had other dermatological disorders. Intrahepatic cholestasis of pregnancy (ICP) was the most common pregnancy-specific dermatosis (40%), followed by atopic eruption of pregnancy (13.8%) and polymorphic eruption of pregnancy (6.3%). Infectious conditions included scabies (11.3%), tinea corporis (7.5%), chickenpox (3.8%), genital herpes (2.5%), and tinea cruris (1.3%). Most cases (77.5%) presented in the third trimester, except atopic eruption, which appeared earlier. Pruritus was the universal complaint in ICP, whereas pemphigus vulgaris and vitiligo manifested primarily with lesions. The rural residence, lower socioeconomic status, and exposure to irritants such as detergents were identified as aggravating factors. Maternal complications included pre-eclampsia (25%), preterm labor (10.4%), and postpartum hemorrhage (14.6%) among ICP cases. Fetal distress (29.2%), low birth weight (51.2%), birth asphyxia (27.1%), and stillbirths (8.3%) were significantly more common in pregnancy-specific dermatoses, particularly ICP. NICU admissions were also higher in this group (33.3%). Conclusion: The findings of present study showed that pregnancy specific dermatoses and infections are the mainstay of dermatological disorders during pregnancy while a sizeable proportion of women also have other skin disorders like pemphigus vulgaris, psoriasis etc. Majority of maternal and perinatal complications were seen in pregnancy specific dermatosis group especially in ICP subjects. Utmost care is advocated for these patients.