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Treating common ear problems in pregnancy: what is safe?

Petros V Vlastarakos1, Thomas P Nikolopoulos, Leonidas Manolopoulos

  • 1ENT Department, Hippokrateion General Hospital of Athens, 114 Vas. Sofias Av., Athens, Greece. pevlast@hotmail.com

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
|November 24, 2007
PubMed
Summary

This review outlines safe medication options for pregnant women with ear conditions, emphasizing cautious use of certain drugs and contraindications for others. ENT surgeons need guidelines for effective treatment during pregnancy.

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Area of Science:

  • Otolaryngology
  • Pharmacology
  • Obstetrics

Background:

  • Over 80% of pregnant women use medication, often for ear, nose, and throat (ENT) issues.
  • Otologic and neurotologic conditions significantly impact pregnant women's quality of life.

Purpose of the Study:

  • To review the literature on the safety and administration of medical treatments for ear diseases in pregnant women.
  • To provide guidance for ENT surgeons on medication use during pregnancy.

Main Methods:

  • Comprehensive literature review including Medline, databases, electronic links, books, and guidelines.
  • Inclusion of various study types: clinical trials, reviews, systematic reviews, meta-analyses, and case reports.

Main Results:

  • Relatively safe medications include beta-lactam antibiotics, macrolides (with caution), and acyclovir.
  • Other usable medications include non-selective NSAIDs (pre-32 weeks), nasal decongestants (cautiously), intranasal corticosteroids (budesonide preferred), certain antihistamines, H2 antagonists, and proton pump inhibitors.
  • Contraindicated drugs include selective COX-2 inhibitors, betahistine, and vasodilating agents. Antiemetics and specific treatments for Meniere's disease have cautious recommendations.

Conclusions:

  • ENT surgeons must be aware of medication safety guidelines for treating pregnant patients with ear conditions.
  • Appropriate medication selection is crucial for managing otologic symptoms and improving maternal quality of life during pregnancy.