The physiological skin changes tend to remain for sometime after delivery; but they usually fade, often not completely, with time. Pigmentation can be lightened with bleaching cream; but the stretch marks usually lighten in color but rarely disappear. Creams advertised to prevent stretch marks generally do not work. Most skin diseases during pregnancy are harmless to the baby. However, Rubella (German measles), Syphilis and Genital Herpes Simplex Infection can be harmful to the baby in the womb.
a) Rubella (German measles) (Fig 3)
This infection is caused by a virus which is spread by coughing and sneezing. Shortly after infection with the rubella virus, a non-itchy rash appears all over the body which lasts for 2-3 days. If infection occurs during the first 4 months of pregnancy, the baby may develop birth defects or may even die within the uterus. All females should be vaccinated against Rubella during childhood; but no females should be vaccinated during pregnancy.
b) Syphilis (Fig 4)
Syphilis is a sexually transmitted disease. In the early stage of syphilis, painless ulcers appear in the genitals which heal spontaneously within 3 weeks even without treatment. Rashes appear on the skin, palms, soles and mouth 6-8 weeks later. If infection occurs during pregnancy, the baby may be born with heart-, bone- and brain-defects. All women are routinely tested for syphilis during their regular check-up for pregnancy in Singapore.
c) Genital herpes
Herpes simplex infection is caused by a virus. Infection of the genitals is usually acquired by sexual contact. It is often a recurrent disease. It presents as painful blisters and sores on the genitals and the virus may be present in the vagina even without symptoms (Fig 5). During delivery, the baby may become infected by the virus, causing infection on the skin, in the brain, and liver. Infection of the newborn can be prevented by ensuring that the mother's infection is under control during delivery; a Caesarean section may be necessary.