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Itching, or an unpleasant sensation that provokes a desire to scratch, is one of the most common skin problems in pregnant women. It can be caused by skin diseases, diseases affecting the whole body, or simply by having dry skin, known as generalised itching. The growing uterus also stretches the skin around the belly and the skin containing oil glands which keep it moist are not able to meet the moisture requirement, leading to dry skin. For the pregnant woman, having itchy skin can add anxiety, frustration and lead to poor sleep and exhaustion. She may also cause skin damage from scratching.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: February 19, 2016

Melasma is a psychologically distressing skin disorder also known as ‘chloasma’ or ‘mask of pregnancy’. Darker patches of skin gradually develop on the cheeks, forehead, nose, and upper lip. It is more common in women and is associated with pregnancy and medication containing hormones. Melasma is divided into three types: epidermal, dermal, and mixed melasma. Epidermal melasma is the most superficial with an increase in the skin pigment (melanin) in the top layer of skin (epidermis). In dermal melasma, there is increased skin pigment in the second deeper layer of the skin (the dermis). Mixed melasma is a combination of epidermal and dermal melasma.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 7, 2010

Evidence is inadequate to advise women to avoid specific foods during pregnancy or breastfeeding to protect their children from allergic diseases like eczema and asthma.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: September 12, 2012

Pregnancy is a time of change, especially if it's your first. Parents-to-be may have feelings ranging from joy and hope to worries and anxiety: How will everything go? What will life with a baby be like?

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: March 22, 2018

Around 50% of women of childbearing age are either overweight [body mass index (BMI) 25–29.9 kg/m2] or obese (BMI ≥ 30 kg/m2). The antenatal period provides an opportunity to manage weight in pregnancy. This has the potential to reduce maternal and fetal complications associated with excess weight gain and obesity.

Health Technology Assessment - NIHR Journals Library.

Version: July 2012

This clinical guideline concerns the management of hypertensive disorders in pregnancy and their complications from preconception to the postnatal period. For the purpose of this guideline, ‘pregnancy’ includes the antenatal, intrapartum and postpartum (6 weeks after birth) periods. The guideline has been developed with the aim of providing guidance in the following areas: information and advice for women who have chronic hypertension and are pregnant or planning to become pregnant; information and advice for women who are pregnant and at increased risk of developing hypertensive disorders of pregnancy; management of pregnancy with chronic hypertension; management of pregnancy in women with gestational hypertension; management of pregnancy for women with pre-eclampsia before admission to critical care level 2 setting; management of pre-eclampsia and its complications in a critical care setting; information, advice and support for women and healthcare professionals after discharge to primary care following a pregnancy complicated by hypertension; care of the fetus during pregnancy complicated by a hypertensive disorder.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: August 2010

Diet and activity interventions in pregnancy reduce gestational weight gain, with no significant benefit for a composite of maternal and fetal outcomes, irrespective of maternal characteristics, and are not cost-effective

Health Technology Assessment - NIHR Journals Library.

Version: August 2017

The original antenatal care guideline was published by NICE in 2003. Since then a number of important pieces of evidence have become available, particularly concerning gestational diabetes, haemoglobinopathy and ultrasound, so that the update was initiated. This update has also provided an opportunity to look at a number of aspects of antenatal care: the development of a method to assess women for whom additional care is necessary (the ‘antenatal assessment tool’), information giving to women, lifestyle (vitamin D supplementation, alcohol consumption), screening for the baby (use of ultrasound for gestational age assessment and screening for fetal abnormalities, methods for determining normal fetal growth, placenta praevia), and screening for the mother (haemoglobinopathy screening, gestational diabetes, pre-eclampsia and preterm labour, chlamydia).

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: March 2008

Pregnancy, childbirth, postpartum and newborn care: a guide for essential practice (3rd edition) (PCPNC), has been updated to include recommendations from recently approved WHO guidelines relevant to maternal and perinatal health. These include pre-eclampsia & eclampsia; postpartum haemorrhage; postnatal care for the mother and baby; newborn resuscitation; prevention of mother-to- child transmission of HIV; HIV and infant feeding; malaria in pregnancy, interventions to improve preterm birth outcomes, tobacco use and second-hand exposure in pregnancy, post-partum depression, post-partum family planning and post abortion care.

World Health Organization.

Version: 2015

Clinical guidelines have been defined as ‘systematically developed statements which assist clinicians and patients in making decisions about appropriate treatment for specific conditions’. This clinical guideline concerns the management of diabetes and its complications from preconception to the postnatal period. It has been developed with the aim of providing guidance on:

NICE Guideline - National Collaborating Centre for Women's and Children's Health (UK).

Version: February 2015

This guideline contains recommendations specific to twin and triplet pregnancies and covers the following clinical areas: optimal methods to determine gestational age and chorionicity; maternal and fetal screening programmes to identify structural abnormalities, chromosomal abnormalities and feto-fetal transfusion syndrome (FFTS), and to detect intrauterine growth restriction (IUGR); the effectiveness of interventions to prevent spontaneous preterm birth; and routine (elective) antenatal corticosteroid prophylaxis for reducing perinatal morbidity. The guideline also advises how to give accurate, relevant and useful information to women with twin and triplet pregnancies and their families, and how best to support them.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: September 2011

In 2003, NICE first issued guidance on the use of routine preoperative tests for elective surgery (NICE CG3). The guideline evaluated the practice of routinely performing preoperative diagnostic tests for elective surgery in healthy and comorbid populations.

NICE Guideline - National Guideline Centre (UK).

Version: April 2016

Study found insufficient evidence to support definite clinical recommendations regarding vitamin D supplementation in pregnancy. Although there is modest evidence to support a relationship between maternal 25-hydroxy vitamin D [25(OH)D] status and offspring birthweight, bone mass and serum calcium concentrations, these findings were limited by their observational nature (birthweight, bone mass) or risk of bias and low quality (calcium concentrations).

Health Technology Assessment - NIHR Journals Library.

Version: July 2014

This guideline aims to: identify and describe best practice for service organisation and delivery that will improve access, acceptability and use of services; identify and describe services that encourage, overcome barriers to and facilitate the maintenance of contact throughout pregnancy; describe additional consultations with and/or support and information for women with complex social factors, and their partners and families, that should be provided during pregnancy, over and above that described in the NICE guideline ‘Antenatal care: routine care for the healthy pregnant woman’ (2008) (clinical guideline 62); identify when additional midwifery care or referral to other members of the maternity team (obstetricians and other specialists) would be appropriate, and what that additional care should be.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: September 2010

For women with favourable cervix, the study found that misoprostol and oxytocin with amniotomy are more likely to be successful than other agents in achieving vaginal delivery within 24 hours. Cost-effectiveness analysis suggested that titrated (low-dose) oral misoprostol solution and buccal/sublingual misoprostol were most likely to represent value for money, although there was a lot of uncertainty in the cost-effectiveness estimates.

Health Technology Assessment - NIHR Journals Library.

Version: August 2016

This guidance is a partial update of NICE clinical guideline 13 (published April 2004) and will replace it.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: November 2011

This guideline intends to show the place of both new and established treatments in the wider care pathway for Crohn's disease. This will be useful for clinicians and people with Crohn's disease because new drugs have been licensed for Crohn's disease in the last decade. The guideline also deals with those medications which are unlicensed for treatment of the condition, but which have been used in this way (off-label) for many years and their role is recognised in other NICE documents as well as the British National Formulary. They include azathioprine, mercaptopurine and methotrexate. The guideline aims to help improve the care offered to people with Crohn's disease and provide information about the clinical and cost effectiveness of potential care pathways. Management of Crohn's disease in specific populations (for example, in pregnancy) may require special consideration.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: October 10, 2012

Subject indexing assigned by NLM

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

We conducted this systematic evidence review of five key questions to assist the U.S. Preventive Services Task Force (USPSTF) in updating its 2003 recommendation on behavioral counseling to prevent skin cancer (melanoma, basal cell carcinoma, and squamous cell carcinoma).

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: February 2011

Cancers of the skin are the most common forms of cancer. Timely diagnosis and treatment are critical to reducing the rates of morbidity and mortality. Newer noninvasive imaging technologies may assist with earlier detection.

Comparative Effectiveness Technical Briefs - Agency for Healthcare Research and Quality (US).

Version: September 2011

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