Treatment of otitis in pregnant women. Acute purulent otitis media. Complications of otitis media during pregnancy

Pregnancy is an amazing time in the life of every woman. But while carrying a child, immunity decreases, and the expectant mother may get sick various infections more often than other family members. Otitis media during pregnancy is not at all uncommon. This is explained by the fact that the entry gate for most pathogenic bacteria is the nasopharynx, which is directly connected to the ears. It seems that there is nothing wrong and otitis media can be treated, but this is where the problem arises, since not all treatment methods can be used during pregnancy.

Otitis - what is it

1. Many people know firsthand what otitis media is. Some have personally suffered from this disease, while others have had children or relatives. This pathology is accompanied by severe pain in the ears, so those who have ever had otitis media are unlikely to forget how painful and unpleasant it is. If you believe medical statistics, almost 80% of children manage to get otitis media at least once before the age of 3.

Otitis is an acute or chronic inflammatory process in one or both ear canals. Accordingly, it is defined by doctors as unilateral and bilateral. In addition, according to the discharge from the ears, otitis media can be catarrhal or purulent. However, the most important classification is considered to be the location of the inflammation process. So inflammation can be external, middle or internal. Otitis media is most often diagnosed, which is why it is necessary to consider this disease in detail in pregnant women.

Treatment of otitis media in pregnant women is difficult, since a number of medications have a toxic effect on the fetus.

Causes of the disease

Otitis media rarely occurs during pregnancy independent disease. Most often it begins under certain factors. The main causes of otitis media can be identified as follows:

• Respiratory illnesses or flu, especially if a woman gets sick too often;
• Some infectious diseases in which pathogenic bacteria enter the middle ear with the bloodstream;
• Hypothermia;
• Water entering the middle ear cavity.

Throughout pregnancy, a woman is susceptible inflammatory diseases nose and ears, since during pregnancy the nasal mucosa and auditory tube swell somewhat, which is considered a physiological condition.

Pregnant women are often diagnosed with sinusitis and otitis, but when proper treatment these pathologies disappear without a trace after childbirth.

What symptoms should you be wary of?

If otitis occurs, no one should self-medicate, let alone pregnant women. You should immediately consult a doctor if the following specific symptoms appear:

• feeling of fullness in the ear or ears;
• hearing loss;
• constant ringing in the ears, which resembles a shell attached to the auricle;
• lumbago in the sore ear, sometimes the pain is simply unbearable;
• general weakness and decreased performance;
• constant headache;
• heat.

But practicing ENT doctors often observe a picture when the disease in pregnant women occurs latently, without obvious symptoms. That is, of course, there is pain, but it is quite tolerable and the woman does not always pay attention to it, thinking that the ear is simply blown. The temperature may remain normal or low-grade. A pregnant woman may come to the doctor complaining of frequent headaches and severe weakness, while the inflammatory process in the ear is in full force. This makes it somewhat difficult to make a quick diagnosis. To avoid complications, a pregnant woman should go to the hospital when the first symptoms appear. warning signs diseases.

We must not forget that untreated otitis media can lead to this dangerous disease like meningitis.

Protocol for the treatment of otitis media in pregnant women

Otitis media during pregnancy should be treated in accordance with the same rules as when treating other diseases in pregnant women. The basic principle is that you need to select drugs and methods that can bring more benefits woman than harm to the child.

If diagnosed purulent otitis media middle ear, then for effective treatment you simply need to take a course of antibiotics. These drugs are selected by the doctor individually, based on the duration of pregnancy and the severity of the disease. Antibacterial drugs are selected under such conditions that they have as little effect as possible on the growing fetus. Deny antibacterial therapy is not possible, as the disease may be complicated by perforation eardrum and the entry of pus into the skull.

Sometimes the pus does not find a way out of the ear cavity, in which case the doctor local anesthesia pierces the membrane. This operation is necessary for successful treatment, and no matter how scary it may sound, if the pregnant woman testifies, you need to agree to such manipulation.

After the pus is released, the patient's condition improves. During treatment, the tympanic membrane completely heals on its own and hearing returns to normal.

After the purulent contents leave the ear cavity, the canal is carefully treated with antiseptic agents.

Catarrhal otitis is much easier than purulent otitis. Its difference also lies in the fact that it is quite possible to do without antibiotics. In this case, all treatment comes down to removing swelling and inflammation from the auditory tube. This is necessary so that the fluid accumulated in the area of ​​the eardrum spontaneously flows out of the ear canal. This effect can be achieved by blowing the nose with a special apparatus or by performing pneumomassage of the eardrum. IN such a case The auditory tube opens due to changes in pressure in the nasal cavity and ears.

Treatment of otitis media during pregnancy is complemented by various local means. So, during treatment, small cotton wool turundas are inserted into the ear canal, which are pre-moistened in anti-inflammatory or antibacterial agent, which is allowed during pregnancy and does not affect the unborn child.

It must be remembered that any medications during pregnancy can only be used on the recommendation of a doctor.

What drugs can be used by pregnant women

Many women are afraid to go to the doctor with otitis media, fearing that the prescribed treatment may harm the child. This approach wastes precious time, and the disease can quickly become chronic or develop complications. On early stage the doctor will be able to choose a gentle treatment that will help well to the expectant mother and not harm the baby at all.

If the pregnancy is short, then the woman must inform the doctor about her situation.

In cases where otitis media is not purulent, vasoconstrictor nasal drops must be prescribed. These drugs effectively eliminate swelling in the area of ​​the auditory tube, due to which the patient’s condition quickly improves. However, such drops are selected by the doctor with great care and the dose is also calculated individually, the fact is that they can provoke a narrowing of the blood vessels of the placenta, which will disrupt the flow of blood to the fetus. During pregnancy, a children's form of the drug is most often prescribed, for example, Nazivin in a dilution of 0.01%.

To eliminate pain, they can be prescribed ear drops Otipax, this drug works only locally and is approved for use during pregnancy. Pregnant women can drop 3 drops into each ear canal, up to three times per day. It is worth considering that if there is purulent discharge, then this drug cannot be used.

If the eardrum is perforated, the use of Otipax is strictly prohibited. If the medication gets into the middle ear, it can cause hearing loss.

Traditional methods of treatment

Traditional recipes will help speed up recovery, but only if they are used correctly in conjunction with the treatment prescribed by the doctor.

• For catarrhal otitis good effect Provides warming with dry heat. For this purpose you can use a special blue lamp or a cotton bag with heated salt.

If pus is released from the ear, then heating it is strictly prohibited. This will only make the situation worse!

• A teaspoon with a heap of dried flowers pharmaceutical chamomile pour a glass of boiling water and leave for about 2 hours. After this, the inflamed ear is washed with the resulting solution several times a day. This can be done with a small syringe or a disposable syringe without a needle.
• Take onions and aloe leaves in equal proportions and grind them in a meat grinder. Turundas are moistened with the resulting juice and placed in sore ear. It is advisable to do this procedure at night.
• Propolis tincture is mixed with vegetable oil in a ratio of 1:4 and the resulting mixture is instilled into the sore ear several times a day. You can add a little honey to the mixture, soak the turundas in it and put it in your ear overnight.

Bee products should not be used by women who are prone to allergies. Even when applied topically, there may be severe swelling.

Should not be used during pregnancy alcohol compresses, as well as any medications that contain alcohol.

How to prevent otitis media in pregnant women

If there is a predisposition to otitis media, then with the onset of pregnancy the woman must exercise extreme caution so as not to get sick. Preventive measures are as follows:

• It is necessary to avoid places where there are large crowds of people, especially during seasonal outbreaks of acute respiratory infections and influenza.
• During pregnancy you need to boost your immunity by everyone accessible ways. This may include high consumption of fruits and vegetables, vitamin complexes, long walks in the air.
• When swimming in pools and open water, you should avoid getting water into your ears.

If preventive measures did not help and the pregnant woman fell ill with otitis media, there is no need to worry too much. At timely application If you go to the doctor, this disease can be treated within a week and does not cause complications. For pregnant women, gentle treatment is selected that does not provide harmful effects for the fruit.

Otitis is an ear pathology that develops as a result of inflammation of the main parts of the hearing organ. The disease may be infectious or non-infectious origin, but in most cases occurs against the background of a general infection of the body. Delayed therapy Otitis affects the health of not only the woman, but also the unborn child.

During the period of gestation, the female body experiences hormonal imbalance, which affects the functioning of the immune system. A decrease in reactivity contributes to the development of conditioned pathogenic microorganisms in the upper respiratory tract, from where they enter the ear through the Eustachian tube. To the diagram conservative treatment pathologies often include antibacterial drugs, however, many of them cannot be taken during pregnancy due to the toxicity of the active ingredients.

Etiology

According to practical observations, the risk of developing ear pathologies in pregnant women it increases at least 3 times. This is due physiological changes in the body arising as a result of fetal development. Excessive secretion of the hormone progesterone contributes to fluid retention in the body, as a result of which the mucous membranes of the ENT organs swell. Indirectly the condition of tissues is affected by an increase in blood pressure, associated with an increase in the amount of blood in the female body.

Swelling of the mucous epithelium lining the inner surface of the Eustachian tube leads to its narrowing. Subsequently, it is violated ventilation function, which leads to the accumulation of exudate in the ear cavity. During development general infection serous exudate turns into a purulent mass, which becomes the cause of purulent otitis media.

In the first trimester of pregnancy, a woman should limit communication with others. During this period, taking medications can negatively affect the health of the unborn child.

It should be noted that reactivity female body decreases during pregnancy due to the following reasons:

• deficiency of vitamins and minerals;
• hormonal imbalance;
• general infections;
• intoxication of the body.

Timely diagnosis and treatment of ear pathology leads to rapid relief of the main manifestations of otitis media. However, experts warn that running forms ENT diseases are difficult to treat, due to the limited list of medications that can be taken during pregnancy.

Symptomatic picture

Otitis media during pregnancy is often practically asymptomatic, which is due to the body’s reduced resistance. For this reason, diagnosing the disease on initial stages its development is not easy. The main symptoms of ENT disease include:

• stuffy ears;
• aching pain in the ear area;
• hearing impairment;
• serous or purulent;
• general malaise and muscle weakness.

Infectious otitis media poses a serious threat to the fetus. Some types pathogens are able to penetrate the placental barrier and provoke hypoxia.

With the development of eustacheitis, women complain of nasal congestion and a feeling of fluid transfusion inside the ear cavity. Such symptoms are a direct indication for seeking help from an otolaryngologist.

Effect on the fetus

The development of otitis media during pregnancy does not affect the fetus, but only in the absence severe complications. In approximately 35% of cases, the disease is complicated by purulent inflammation, which leads to the appearance of mastoiditis, myringitis, meningitis, sepsis, etc. On the background general intoxication body, the risk of developing pathologies in a child increases.

Experts say that the danger lies largely in taking medications that help relieve the symptoms of otitis media. This is especially true for pharmacotherapy in the first trimester of pregnancy. Active development vital important organs and fetal systems occurs precisely during this period. The presence in the blood of toxic substances that are present in pharmaceutical products, can cause pathologies.

By the beginning of the second trimester, the placenta surrounding the fruit, fully formed. It protects the developing organism from the effects of pathogens, which prevents its infection. In addition, the neural tube and most vital organs are already formed. This allows specialists to use more wide circle medications for the treatment of ear pathology.

The placental barrier prevents the penetration of pathogens, but not active substances medications. For this reason, the selection suitable means Pharmacotherapy can only be carried out by a specialist.

For elimination local manifestations For otitis media, anti-edematous, antibacterial and anti-inflammatory drugs are used. Active ingredients, which are part of them, are toxic and therefore cannot be used to treat women during pregnancy. For this reason, the treatment regimen for pregnant women may include approximately the following types of medications:

• "Otipax" - ear drops combined action, having analgesic, decongestant and antiseptic effects;
• "Sofradex" is an antiallergic medicine that helps eliminate swelling, inflammation and itching. Inhibits the development of gram-positive microorganisms that provoke the occurrence of otitis media;
• “Candibiotic” is an antibiotic with analgesic and anesthetic action that kills pathogenic microbes and some types of fungi;
• "Amoxicillin" is an antibacterial drug of the penicillin series that relieves inflammation and allergic manifestations in the mucous membranes of the ENT organs;
• "Biseptol" is a bacteriostatic and bactericidal action, eliminating purulent foci of inflammation in the ear;
• "Amoxiclav" - an antibiotic wide range action, the components of which are active against the majority bacterial pathogens ear pathology.

Important! Vasoconstrictor drops help increase the tone of the uterus, which can lead to miscarriage in the early stages of pregnancy and premature birth in the latter stage.

Physiotherapy

Physiotherapy is one of the main components of the treatment of otitis media in pregnant women, contributing to the regression of inflammatory processes in the hearing organ. Thanks to physiotherapeutic procedures, tissue trophism significantly improves, which promotes epithelization of mucosal lesions, auditory ossicles, eardrum etc. For treating women during gestation the following can be used:

• phototherapy – leads to the elimination of bacteria in areas of inflammation due to irradiation of affected tissues with UV rays;
• UHF therapy – affects the affected tissues with ultra-high frequency currents, which restore blood microcirculation. Stimulates the production of specific antibodies that help eliminate inflammatory processes;
• Politzer blowing - restores the patency of the Eustachian tube, which promotes the outflow of serous contents from the tympanic cavity.

Important! Physiotherapeutic procedures can be used in the inactive phase of otitis development, characterized by the absence of acute inflammation in the hearing organ.

Preventive measures

Treatment of ear pathology is complicated by restrictions that are imposed on the list of drugs suitable for relieving the manifestations of the disease. In 90% of cases, otitis media in pregnant women occurs as a complication infectious disease. That's why key role Strengthening the immune system plays a role in disease prevention. To increase the body's reactivity, experts recommend:

1. avoid hypothermia;
2. take vitamins;
3. promptly treat acute respiratory infections and acute respiratory viral infections;
4. ventilate the room daily;
5. include foods rich in vitamins in your diet.

Whenever the slightest sign illness, you should immediately consult a doctor.

It is important to begin treating otitis media during pregnancy after diagnosis. Shooting pain in the ear indicates the onset of inflammation and possible infection of the ear. In the absence of timely medical care, the prognosis for the fetus is unfavorable. Complications include purulent otitis media, hearing loss, and infection of body systems. Treatment includes taking antibiotics and anti-inflammatory drugs.

Symptoms of the disease in acute form

Disease long time does not manifest itself or the woman has minor symptoms: slight dizziness, fatigue. Symptoms are similar to toxicosis, making it difficult self-diagnosis on initial stage. Gradually, the symptoms begin to increase, and the main signs of otitis media appear:

• pain in the ear or ears varying intensity, worse at night;
• fatigue, lethargy;
• increased body temperature;
• headache;
• purulent discharge from the sore ear;
• tinnitus, congestion.

Otitis media in pregnant women is especially dangerous in the 1st and 3rd trimester. Fruit, after successful conception, is more susceptible to infections and the disease becomes the cause of pathologies in the child. Third trimester - interference of pathogenic microorganisms can lead to placental abruption, premature birth, fetal hypoxia, infection of the child.

Forms and treatment of the disease

1. Otitis externa. Expectant mothers are prescribed neomycin-based ear drops, which are safe for the fetus. Used when there is no evidence of perforation of the eardrum. If it ruptures, drops based on hydrocortisone are prescribed.
2. Bacterial otitis of the inner or middle ear. Penicillin antibiotics (drugs Flemoxin and Amoxicillin) are prescribed, approved for use by pregnant women. Before prescribing, contraindications are studied and the benefits to the mother are compared with the risk to the fetus.
3. Purulent otitis. Antibiotics are prescribed in the form of ear drops or ointments (Levomekol, Vishnevsky ointment).

At purulent form pathology and the formation of a boil, the doctor removes the ulcers and treats the cavity with antiseptics (Miramistin).

For swelling of the ear canal, use vasoconstrictors. They are selected in children's dosages (Nazivin for children).

Permitted and prohibited drugs

At the first signs of ear inflammation, a pregnant woman needs qualified health care. For cupping unpleasant symptoms Ear drops are prescribed.

• It is strictly forbidden to use the drugs “Normax”, “Annauran”, “Tsipromed” and analogues. The substances included in the composition have toxic effect and can lead to hearing loss in the fetus.
• In compliance with the dosage, the following are used for no more than 3 days without medical supervision: “Polydex”, “Otofa”, “Sofradex”. Contraindication: perforation of the eardrum.
• Treatment of otitis during pregnancy is carried out with the drug "Otipax". This safe remedy for cupping ear pain. Does not treat the disease or its cause, but only reduces it painful sensations.

If pus is leaking from the ear, drops cannot be used - they can lead to hearing loss. As first aid, the cavity is cleaned. This will prevent pus from accumulating in the ear cavity.

Difficulties in treatment and choice of drugs

When treating otitis in pregnant women, the form of the disease, stage and trimester are taken into account. At weeks 1-12, incorrectly selected medications can lead to fetal death, miscarriage, and pathologies in the development of vital organs. In the 3rd trimester, the baby is reliably protected by the placenta, but antibiotics can penetrate through it, causing hypoxia. A relatively safe period for treatment is considered to be from 13 to 28 weeks.

But when diagnosing otitis, you should not wait until the second trimester or childbirth. Inflammation is dangerous for the fetus; the infection can spread throughout the body and reach the child through the blood. Infection of the fetus does not go away without leaving a trace.

For uncomplicated otitis, the emphasis is on physiotherapy. They are safe for the patient and child and help relieve inflammation in 5 sessions. The advisability of physiotherapy is discussed with an otolaryngologist and therapist.

What to do with chronic form

If the patient has a history chronic otitis media, relapsing several times a year, she needs to adhere to the rules of prevention to prevent exacerbation. In case of persistent hearing loss, it is indicated surgical treatment under local anesthesia. Surgical intervention will not affect the development of the fetus, but it is recommended to postpone it until the 2nd trimester.

A woman needs to find out how to stop relapses at the beginning of pregnancy by contacting an otolaryngologist. The doctor will prescribe medications used in the initial acute stage and allowed for expectant mothers.

First aid

Methods suitable for pain relief alternative medicine. Use the listed methods without a doctor’s prescription for no more than 3 days.

1. Warm warmth will help relieve discomfort. olive oil. Place it in the affected ear and lie on the opposite side. Do not use if the eardrum is ruptured.
2. Hold a bag of salt heated in the microwave or in a frying pan near the sore ear. It is not recommended to use for purulent otitis after perforation of the membrane.
3. Prevention respiratory diseases And timely treatment A runny nose prevents ear diseases. If your nose is stuffy, massage your nostrils, septum, and take more fluids.
4. Reduce pain steam inhalations. Inhaling warm steam does not eliminate the disease, but it does help relieve symptoms temporarily. Contraindication: high temperature.
5. If the pain covers your head and causes a migraine, place a towel soaked in cool water on your forehead.

It is not recommended to treat otitis media during pregnancy using boric alcohol. It is able to penetrate into the blood and through the placenta to the baby. Boric alcohol often does more harm than good, and the advisability of its use is discussed with your doctor.

The impact of unfavorable factors on a woman’s body is limited:

• Antipyretics and painkillers should not be used unless strictly necessary and prescribed by a doctor;
• when pus is discharged, do not heat the ear;
• When going outside, wear a hat to protect your ears;
• clean the ears carefully, especially when pus is discharged;
• include vegetables, fruits, fish in the diet, exclude carcinogenic and allergenic foods.

Before treating otitis media, a pregnant woman is advised to give up work and usual activities, taking unplanned days off. Bed rest, proper nutrition And good sleep- important components of a quick recovery.

Treatment does not stop when symptoms subside. Chronic form proceeds unnoticed by the patient, providing adverse effect for the fruit.

Permitted traditional medicine

On the recommendation of a doctor, the main treatment is supplemented with alternative medicine. It is advisable to use recipes for local application, and not oral - the effect of many plants on the fetus has not been studied and the consequences of consuming decoctions are unpredictable.

• Moisten cotton wool in aloe and Kalanchoe juice, taken in equal proportions. Place in the sore ear for 1-2 hours, repeat twice a day. This method helps reduce pain and is suitable for use before bedtime to relieve discomfort at night time.
• Cut a geranium leaf, rinse with water, and crush with your fingers. Place in ear for 1-2 hours. Not always suitable for pregnant women due to unpleasant odor plants. But if geranium does not cause nausea, use it twice a day to relieve inflammation.
• Mix propolis tincture with vegetable oil. Place 4-5 drops into the sore ear, covering cotton swab for 15 minutes. Use the product 3-5 hours after instilling the medication.
• Rinse ears with warm broth bay leaf. Repeat no more than once a day. Do not use if the eardrum is perforated.
• Rinse ear canal chamomile decoction.
• Squeeze the juice onions, moisten a cotton pad in it and place it in the sore ear for 2 hours.

Preventive measures to prevent disease

Weakening of the immune system during pregnancy contributes to the rapid development of pathology. To exclude chronicity of the disease and complications dangerous to the health and life of the fetus, you should contact an otolaryngologist at the first symptoms. Self-medication is unacceptable.

Otitis media is a common inflammatory disease. It is characterized by severe throbbing pain, noise in the ears and head, weakness, and fever. Pregnant woman is in the zone increased risk because of weak immunity and difficulties in choosing medications for treatment. But in its initial form, if the therapy is chosen correctly, the disease goes away quickly.

Probably, today it can be argued that all those who in this life had the opportunity to personal experience To understand what otitis media is, one becomes uneasy only at the mere mention of this disease. And believe me, this is not surprising, because sharp pains with otitis media this is one of the most serious pains in general. As a rule, this disease is treated with strong antibiotics. However, what to do if the diagnosis of “otitis media” was made to a young woman who is already carrying an unborn child under her heart? What kind of treatment in this case will be most effective and, at the same time, safer for the baby?

What is otitis media?

So, otitis media is acute inflammation mucous membrane of the ear, and it makes absolutely no difference which one - external, middle or even internal. Thus, with otitis externa, inflammation is usually observed skin the outer part of the ear canal, but with otitis media, inflammation is observed in the tympanic cavity (directly behind the eardrum). To tell the truth, it is necessary to take into account that sometimes the pain felt in the ear can be caused by some other reasons that will have absolutely nothing to do with the ear itself. And, as a rule, otitis media can occur as a complication, say, after colds, acute respiratory infections, acute respiratory viral infections, or influenza, but often the real reason Such inflammation can occur once it gets directly into the ear.

If a pregnant woman begins to be bothered by a sharp shooting pain in the ear, urgently send her to her doctor. And remember that in this case it will not be possible to apply any hot compresses, heating pads, or boiled hot eggs to the sore ear! This can lead to very dangerous conditions in case she started purulent inflammation. And in the event that over the next few hours you do not have the opportunity to visit a qualified doctor, and the pain only grows and begins to greatly bother the pregnant woman, it will be quite possible to do several non-dangerous independent steps. So, for example, it will be quite possible to put any drops into your nose vasoconstrictor drops. Moreover, it could be the banal Nazivin (drops that are intended for children are also quite suitable). But Otinum may be dropped into the ear. However, when you go to your doctor, just put on a cap or some kind of scarf, this is necessary in order to protect your sore ear from strong drafts or sudden hypothermia.

Treatment of acute otitis during pregnancy

It should be noted that when pregnancy occurs, the list of the most frequently prescribed drugs for such treatment is quite narrow. And therefore for treatment acute otitis in this category of patients it is customary to use medicines, manufactured exclusively at plant based, or based solely natural oils. And, in addition, doctors try to prescribe vasoconstrictors as rarely as possible. Since this is the category medicines are extremely undesirable for use during pregnancy (after all, they can have an extremely negative effect on placental blood flow), they are prescribed with extreme caution.

Let us immediately note that of the many medications intended for instillation directly into the ear, all pregnant women may be allowed to use only a drug such as Otipax. Because it is he who can help eliminate sharp pain without harming the fetus. But it is also necessary to know that Otipax cannot be instilled if a woman has some damage to the eardrum.

Powerful antibacterial drugs play a special role in the treatment of acute otitis media. However, they are prescribed to pregnant women with the greatest caution and, of course, only when such a prescription is caused by an urgent need, for example, the accumulation of pus in the ear and sharp increase woman's body temperature. The doctor, of course, will carefully select you necessary drug. This may well be a drug such as Amoxicillin or even Biseptol.

If a woman’s eardrum is damaged and a large amount of pus flows directly from the ear, the doctor will have to organize treatment in such a way as to eliminate such phenomena as soon as possible. And, as a rule, the place in the eardrum that was perforated completely heals very quickly. But if pus has already accumulated behind the eardrum, then it may not have a real opportunity to come out, since the eardrum is already intact, then the doctor will have to make a small incision (or puncture), giving the necessary opportunity for this pus to flow out calmly.

And of course, if a pregnant woman follows her doctor’s instructions as strictly as possible, then literally within a week nothing will bother her. However, in such a situation, you should not cancel the full course of treatment yourself. But the point is, what is the disappearance of an acute pain symptom doesn't mean yours at all full recovery. And therefore you will need to tune in to carry out full course treatment. Remember that for complete cure from otitis of any form it takes at least two, and in some cases even three weeks.

Pregnancy – difficult period for the woman's body. Under the influence of hormonal and metabolic changes in the body, major changes. Some of them become a factor in the development of diseases.

Ear pain during pregnancy should be a concern expectant mother, since during the gestation period the likelihood of a disease such as otitis media increases. Doctors use this term to designate an inflammatory process in one of the parts of the ear.

Otitis media during pregnancy is associated with a number of unpleasant symptoms and can complicate pregnancy. To prevent this, you need to select effective treatment, which will not harm the fetus.

Causes

Why does otitis media occur during pregnancy? Immediate cause The disease is inflammation caused by pathogenic microbes. The pathogens may also be representatives opportunistic flora skin and mucous membranes.

These microbes are normally suppressed immune system women, however, during pregnancy the following occurs:

• Natural immunosuppression occurs to protective systems mothers did not respond to antigens from the fetal bloodstream.
• Nonspecific resistance of the skin and mucous membranes decreases.
• A pregnancy dominant occurs in the brain, which can reduce impulses from peripheral tissues.
• The general metabolism in the body changes, most of the synthesized substances reach the fetus to the detriment of its own body.

Any factor that can cause otitis infectious process in another organ of the woman. With the blood, the microbe is able to penetrate the structures of the ear and cause an inflammatory reaction. The situation is complicated by the fact that treating infections during pregnancy is quite difficult, all it takes is choosing an antibiotic that is safe for the baby.

All of these factors may be prerequisites for the development of otitis media. If a woman has previously suffered from this disease, the likelihood of otitis media increases sharply during pregnancy.

Classification

Since the human ears have a rather complex structure, there is a special classification of otitis media, which helps the specialist doctor navigate which one. pathological process observed in the patient.

Human ears are divided into 3 sections:

• External ear - includes the pinna and the external auditory canal, which extends to the eardrum. Inflammation called otitis externa may occur at this site.
• Middle ear presented tympanic cavity. Inflammation most often occurs in this area. It's called otitis media.
• The inner ear is a labyrinth structure. Otitis media can also be localized here.

The outer ear becomes inflamed when there is a nearby source of inflammation, for example, purulent boil, or spontaneously when a pathogenic microorganism enters.

The middle ear is a cavity connected to other spaces through narrow canals, this predisposes the occurrence of inflammatory process. Otitis here can be acute and chronic.

The inner ear becomes inflamed quite rarely. Since the labyrinth is a closed cavity, inflammatory exudate enters here with the blood or through a perforation in the membrane from the middle ear.

There is another classification of otitis media. They are divided into:

1. Catarrhal - with viral inflammation and at the very beginning of the bacterial.
2. Purulent - the ear becomes inflamed under the influence of bacteria, the process is more severe.

Symptoms

Symptoms of the disease during pregnancy are not particularly different. The severity of the manifestations of the disease depends on the location and severity of the inflammatory process, as well as on the nature of the pathogen.

The main manifestations of otitis:

• The disease often begins with a feeling of congestion in the ear, and sometimes there is a feeling of noise.
• The temperature rises. Listed symptoms in the affected ear grow.
• Then the pain suddenly appears, it gradually intensifies and sometimes becomes extremely severe. The pain radiates to the jaw area, neck, and throat. Sometimes there is irradiation of pain into the orbit.
• The temperature reaches 40 degrees. During this period, pronounced inflammatory changes are observed in the blood.
• Then the pain gradually decreases, if during the illness the eardrum is perforated, pus begins to flow from the ear.
• Noise and hearing impairment persist, body temperature gradually normalizes.

If pain increases sharply during otitis media, this is an unfavorable sign of impending perforation of one of the membranes of the inner ear.

Any pain in this area should bring the pregnant woman to the doctor. The process needs to be treated as early as possible.

Diagnostics

Before choosing ear drops or another method of treating the disease, the doctor must confirm the diagnosis. To do this, specialists use the following procedures:

• Examination of the ear through an otoscope.
• Valsava's test to determine the mobility of the eardrum.
• Hearing examination, audiometry.
• Tympanometry is the study of sound conduction in the middle ear.
• Computed tomography is rarely used.
• Endoscopy of the pharyngeal opening auditory tube– to identify the cause of otitis media.
• Tympanopuncture is a puncture of the membrane to remove fluid from the middle ear for analysis. Performed for diagnostic and therapeutic purposes.

In most cases, the methods listed are sufficient to make a diagnosis and find out the location of the inflammation.

Treatment

It is necessary to treat otitis different ways depending on its shape. Otitis externa during pregnancy is treated at home using the following methods:

• Rinsing the outer ear, removing pus.
• Ear drops with antibiotics and anti-inflammatory components.
• Antipyretics - only for high temperatures.
• Antibiotics and antivirals in the form of tablets.
• B vitamins, vitamin C.

Otitis media is most often treated in a hospital setting to prevent pregnancy complications:

• Treatment includes antibiotic tablets.
• Local remedies must be used - ear drops with antibacterial, anti-inflammatory, analgesic components.
• Antipyretic drugs.
• Physiotherapy procedures during pregnancy are rarely performed; the doctor decides on the feasibility individually.
• Blowing of the auditory tube is not always done.
• Vasoconstrictor nasal drops – reduce pressure in the middle ear.
• Puncture of the middle ear to evacuate pus.
• Surgical treatment – ​​according to indications.

Internal otitis is a severe form of the disease, requiring hospital treatment, often requiring surgical intervention.

Otipax

It is necessary to treat otitis with local remedies; they are used for the treatment of moderate and internal inflammation in the ear. One of the most popular and effective drugs is Otipax. Can it be used during pregnancy?

Otipax is combined agent– it contains the substances lidocaine and phenazole. In combination, they can provide a number of therapeutic effects:

1. Phenazole is a non-steroidal anti-inflammatory drug that reduces the severity of the inflammatory reaction.
2. Swelling decreases and hearing perception improves, the pathological process stops.
3. Soon after starting treatment with Otipax drops, the temperature returns to normal.
4. Lidocaine is an anesthetic - it effectively reduces the severity of pain.
5. A sterile solution of Otipax drops allows you to have an antiseptic effect, mechanically removing pus and bacteria.

Otipax can be used during pregnancy as symptomatic drug. The manufacturer indicates the lactation period as contraindications; feeding the baby must be stopped during use.

Remember that Otipax does not contain antibiotics and only eliminates the manifestations of the disease.

Other drugs

Drops and tablets are the main method of treating otitis media. These forms are used for therapy with such means as:

• Antibiotics - metronidazole, gentamicin, azithromycin and nitrofurans are acceptable. Fluoroquinolones, often used to treat otitis media, are prohibited during pregnancy.
• Local anesthetics – Otirelax, Otinum, Anauran. The listed drops contain analgesics approved during pregnancy.
• Anti-inflammatory drugs - NSAIDs and glucocorticosteroids. Can be used in drops the following drugs: Polydexa, Sofradex.

It is up to the attending physician to choose which drops or tablets to use for a particular patient. Do not risk the health of yourself and your baby during pregnancy, contact a qualified specialist in a timely manner.