Pruritic urticarial papules and plaques of pregnancy in twin and triplet pregnancies

Background Pruritic urticarial papules and plaques of pregnancy (PUPPP) is a common dermatosis of unknown aetiology. Multiple pregnancies occur freque ntly in most reported series of PUPPP and increased abdominal distension ha s been considered a factor in its causation. Objectives To determine the frequency of PUPPP in twin and triplet pregnanc ies. Methods A retrospective review of all the records of patients delivered of twin or triplet pregnancies over an 18-month period at a busy general mater nity hospital. Results One hundred and thirty-eight women delivered twins, four of whom de veloped PUPPP (2.9%). Fourteen women delivered triplet pregnancies, two of whom developed PUPPP (14%). Four of these six multiple pregnancies were con ceived by in vitro fertilization. Conclusions The reported rate of PUPPP in single pregnancies is 1 in 200 (0 .5%). Our findings suggest that multiple pregnancies are at a higher risk o f developing this cutaneous eruption with 2.9% of twin and 14% of triplet p regnancies affected in our study.