PUPPPs and how it changed my pregnancy

Until a few weeks ago, I had never heard of PUPPS: Pruritic Urticarial Papules and Plaques of Pregnancy. Plague seems like the key word as it is basically a painful rash experienced by less than 1% of pregnant women in the last several weeks of pregnancy.  There is no cure and the best way to alleviate symptoms is to have the baby.

For me it started around week 36 as itchy raised red stretch marks around the belly. It stayed confined to my belly until week 38. Then, overnight, it spread across my body from neck to toes. It was alarming how quickly it spread. When I called the doctor’s office, the nurse told me this was quite common and to take some Benadryl and calamine lotion and then see my doctor at our appointment scheduled in two days. I did take some time to convince her of the alarming spread, but was left with reassurances that it was all quite common.  I spent the next two days in agony, the kind where you want to peel off your skin. That is when I googled pregnancy rash and first got the name for this condition - PUPPPs.

PUPPPs on my hand and arm

When I saw my doctor she was not happy with the nurse who spoke to me on the phone. From that point on, I never heard a practitioner who didn’t say severe or extreme before mentioning my PUPPPs. The doctor recommended immediate induction as the only way to combat the rash is to have the baby. A stress test showed that baby was still doing just fine. Other tests ruled out more alarming reasons for the rash. I wasn’t quite ready for the induction option as I wanted to make it to 39 weeks. So we made a plan to come back on Monday when we would reach 39 weeks. The new drugs from the doctors didn’t provide any more relief. Lukewarm baking soda baths were about the best I could do for temporary relief. This continued itchy pain meant that I was unable to really rest. Knowing that wasn’t something that could go on, we packed our bags and went to the doctor on Monday. They gave me the option to keep toughing it out, but highly recommended induction. However, the birthing unit was a bit busy so we were asked to come back to the hospital later that night. 

 

We were admitted at 6pm. I really liked the care I received at St. Joseph’s Hospital. It is a teaching hospital and my case of PUPPPs provided a teachable moment. Again all the doctors remarked how this was the worst case or one of the worst cases of PUPPPs they had seen. About 80% of my body was raised red and bubbly. I was more red than white.

 

Fast forward to Kiri Joy being born on Wednesday just after midnight via emergency c-section (a story for another time).  It was a wonderful time as we celebrated the birth of our daughter, the beginning of a new chapter in life and the end of a long labor ordeal. As for PUPPPs, it immediately stopped spreading which made me very happy. In the first 24 hours after birth the rash receded with remarkable speed. It didn’t fully go away, but the difference was marked. By the second day, the doctors were coming back and very amazed at how the rash had receded.  By the third day, itching was not my most severe symptom and I finally became more physically aware of the fact I had major surgery. 

 

However, on the fourth day as we headed home, my milk came in and the rash reappeared with velocity. Fortunately the reach was not as severe, and with the baby out, I was able to take some stronger steroids and antihistamines to combat the rash. While the drugs have helped in coping, I remain quite itchy to this day.  I remain hopeful that it should clear up about 6-8 weeks after the birth.

One of the small nice features of PUPPPs is that it does not go for your face.  So with long sleeves I simply look like a version of myself who has an itch. 

 

To anyone else who has or had PUPPPs, I feel for you and can relate. I wish I didn’t know about PUPPPs, but all in all, I had a healthy pregnancy and we got the end result we wanted – a healthy baby. Can’t wait to put this PUPPPs chapter behind me.