Complications of pregnancy: PUPPP: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

OBG · Complications of pregnancy: PUPPP

Sample item

A primigravida at 35 weeks has intense itching with erythematous urticarial papules that began within her abdominal striae and spare the periumbilical skin. There are no blisters, and immunofluorescence of a skin biopsy is negative. What is the most appropriate management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Topical steroids, antihistamines and reassurance

Polymorphic eruption of pregnancy (PUPPP) typically starts in abdominal striae of a primigravida in the third trimester and spares the umbilicus. It is self-limiting, carries no fetal risk, and is treated symptomatically with emollients, topical steroids and antihistamines. Pemphigoid gestationis typically starts around the umbilicus with blisters and has positive immunofluorescence.

Option by option

  • A. Ursodeoxycholic acid for presumed cholestasis

    Cholestasis presents with itching without a rash, and the rash here is primary.

  • B. Early delivery by induction of labour

    Delivery is not needed as the condition resolves after birth and does not harm the fetus.

  • C. Oral prednisolone for presumed pemphigoid gestationis

    Pemphigoid gestationis has periumbilical blisters and linear C3 on immunofluorescence, which are absent here.

  • D. Topical steroids, antihistamines and reassurance (correct)

    Correct. This benign condition needs symptomatic treatment only and has no adverse fetal effects.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is D, Topical steroids, antihistamines and reassurance. Polymorphic eruption of pregnancy (PUPPP) typically starts in abdominal striae of a primigravida in the third trimester and spares the umbilicus.

Why is "Ursodeoxycholic acid for presumed cholestasis" not the answer?

Cholestasis presents with itching without a rash, and the rash here is primary.

Why is "Early delivery by induction of labour" not the answer?

Delivery is not needed as the condition resolves after birth and does not harm the fetus.

Why is "Oral prednisolone for presumed pemphigoid gestationis" not the answer?

Pemphigoid gestationis has periumbilical blisters and linear C3 on immunofluorescence, which are absent here.

What concept does this question test?

It tests Complications of pregnancy: PUPPP in OBG. It is self-limiting, carries no fetal risk, and is treated symptomatically with emollients, topical steroids and antihistamines. Pemphigoid gestationis typically starts around the umbilicus with blisters and has positive immunofluorescence.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Complications of pregnancy: PUPPP?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.