Severe, persistent itching in pregnancy with no visible rash — and after cholestasis has been ruled out — can be a sign of an internal medical problem. Common systemic causes include: • iron-deficiency anaemia • kidney disease • liver disease (not pregnancy-related) • thyroid disorders • diabetes mellitus • HIV and other chronic infections • some blood disorders This happens because toxins and metabolic changes can irritate skin nerves — so creams alone are not enough. If itching is severe and p
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