I get an opportunity to see pregnant women regularly in my outpatients.
While dealing with them it is very important to be well versed with the ear,nose & throat issues in pregnancy & consider safe treatment.Also I do not hesitate to communicate with the referring obstetrician in front of the patient as it reduces a lot of their anxiety.
I would like to discuss some of the common ENT manifestations which happen due to physiological & metabolic changes in pregnancy.
The common presentations are nasal symptoms ,aerodigestive tract symptoms,oral changes,thyroid & ear related -hearing & balance symptoms as well as Bell's Palsy.
The commonest nasal symptom is nasal congestion & nose bleeds.These are treated with local medications & its worth noting that even cetrizine is to be avoided especially in the 1st trimester.
The oral manifestions range from pica to change in taste to mild gum bleed due to gingival hyperplasia.The symptoms of gastroesophageal reflux worsen in the third trimester.The management involves antireflux precautions & small frequent meals.The newer generation antireflux medications again to be avoided in the first trimester.
Though the ear symptoms are not very common they can be debilitating.The common presentation is of ear block due to eustachian tube dysfunction.Some of them may lead to fluid in middle ear.The risk of idiopathic facial palsy[Bells palsy] increases in pregnancy.There can also be dizziness due to iner ear fluid imbalance-Meneire's Disease.
There is a risk of thyroid enlargement during pregnancy.Investigations include ultrasound of thyroid & Fine needle aspiration.If malignancy or compression to airway only then surgery is advised in second trimester.
In conclusion,I would like to say that most of the symptoms during pregnancy are self limiting & need supportive treatment.
While dealing with them it is very important to be well versed with the ear,nose & throat issues in pregnancy & consider safe treatment.Also I do not hesitate to communicate with the referring obstetrician in front of the patient as it reduces a lot of their anxiety.
I would like to discuss some of the common ENT manifestations which happen due to physiological & metabolic changes in pregnancy.
The common presentations are nasal symptoms ,aerodigestive tract symptoms,oral changes,thyroid & ear related -hearing & balance symptoms as well as Bell's Palsy.
The commonest nasal symptom is nasal congestion & nose bleeds.These are treated with local medications & its worth noting that even cetrizine is to be avoided especially in the 1st trimester.
The oral manifestions range from pica to change in taste to mild gum bleed due to gingival hyperplasia.The symptoms of gastroesophageal reflux worsen in the third trimester.The management involves antireflux precautions & small frequent meals.The newer generation antireflux medications again to be avoided in the first trimester.
Though the ear symptoms are not very common they can be debilitating.The common presentation is of ear block due to eustachian tube dysfunction.Some of them may lead to fluid in middle ear.The risk of idiopathic facial palsy[Bells palsy] increases in pregnancy.There can also be dizziness due to iner ear fluid imbalance-Meneire's Disease.
There is a risk of thyroid enlargement during pregnancy.Investigations include ultrasound of thyroid & Fine needle aspiration.If malignancy or compression to airway only then surgery is advised in second trimester.
In conclusion,I would like to say that most of the symptoms during pregnancy are self limiting & need supportive treatment.
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