Epistaxis in pregnancy – not to be sniffed at!

Hardy, Joan; Connolly, Catriona; Weir, Christopher

doi:10.1016/j.ijoa.2007.09.003

Cited by 8 publications

(9 citation statements)

References 7 publications

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“…Treatment consists of control of hypertension, saline nasal drops and neosporin ointment for local application. If bleeding does not stop then nasal packing may be required with antibiotic cover [13].…”

Section: Nasal Changesmentioning

confidence: 99%

ENT Changes of Pregnancy and Its Management

Sherlie

Varghese

2012

Indian J Otolaryngol Head Neck Surg

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A unique group of ear, nose, and throat disorders are associated with pregnancy. While most are benign and reverse during the postpartum period, some do not. These disorders may be classified categorically by site into ear, nose, and laryngeal manifestations. The etiology, pathogenesis and management of these disorders are discussed. Therapeutic recommendations are made based on available information. It is especially important to have knowledge of these common manifestations and treat them with precaution considering the possible effects to both the mother and growing foetus during this crucial period.

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Section: Nasal Changesmentioning

confidence: 99%

ENT Changes of Pregnancy and Its Management

Sherlie

Varghese

2012

Indian J Otolaryngol Head Neck Surg

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“…However, if conservative measures fail, epistaxis in pregnancy can be a complex problem and has a distinct differential diagnosis 4. Rarely, life-threatening cases have been reported requiring operative management and even urgent delivery of the baby due to maternal and fetal compromise 2 3 5 6. There is limited evidence regarding the management of severe epistaxis in pregnancy, complicated by the fact that certain products are contraindicated.…”

Section: Discussionmentioning

confidence: 99%

“…Progesterone causes an increase in blood volume, which may both exacerbate vascular congestion and hence bleeding, and may mask blood loss in the event of severe epistaxis due to apparently effective cardiovascular compensation 2 6. Placental growth hormone has systemic effects including vasodilation 2.…”

Section: Discussionmentioning

confidence: 99%

“…The effects of intravenous and inhaled anaesthetics on the fetus are not fully understood, however, there is known to be an increased risk of preterm labour, particularly during the first two trimesters of pregnancy 7. Other considerations include the need for a rapid sequence induction due to an increased risk of gastric aspiration and use of a left lateral tilt on the operating table to prevent aortocaval compression 6. Local anaesthetic and topical vasoconstrictor nasal preparation may be considered but should be used with caution due to the risk of systemic absorption causing decreased uterine blood flow 4.…”

Section: Discussionmentioning

confidence: 99%

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Torrential epistaxis in the third trimester: a management conundrum

2014

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SUMMARYAlthough epistaxis is common during pregnancy, large volume epistaxis is rare. Many standard epistaxis management options are limited in pregnancy due to absolute or relative contraindications. Ear, nose and throat surgeons need to be aware of what options can be used safely and effectively. We present a case of a 32-year-old woman, 32 weeks pregnant, who was admitted with heavy epistaxis refractive to conservative management. Several potential interventions including bismuth iodoform paraffin paste (BIPP) and Floseal were contraindicated or involved additional risk in pregnancy necessitating unorthodox management. This challenging case highlights suitable alternatives for managing large volume epistaxis during pregnancy, as well as discussing the differential diagnosis and relevant investigations. BACKGROUND

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“…Ayrıca östrojen artışı nedeniyle nazal kapiller damarlanmada artma, minör veya majör travma sonrası epistaksis gebelerde %30 oranında sıklıkla görülen durumlardır. Hipertansiyonun gebelikte ortaya çıkışı epistaksis olgularının görül-mesini kolaylaştırmaktadır (40,41) .…”

Section: Gebelik Ve Epistaksisunclassified

The most frequently encountered rhinologic problems during pregnancy: appropriate approaches toward diagnose and therapy.

Gümüşsoy¹,

Gümüşsoy²,

Çukurova³

2017

Terh

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ÖZOrtalama 40 haftalık gebelik süresi, beraberinde fizyolojik ve hormonal değişiklikleri barındırır. Burun tıkanıklığı ve rinit semptomları gebenin yaşam kalitesini ve uyku düzenini olumsuz etkileyen başlıca sorunlardır. Rinolojik sorunlar, gebelik öncesinde tanı almış (septum deviasyonu, alerjik rinit vb.) ya da gebelik süresince belirginleşen (gebelik riniti, rinosinüzit, vb.) nazal tıkanıklık ve burun akıntısı semptomlarıyla karakterizedir. Aslında dikkatli bir öykü, bize sorunun süresi ve şiddeti hakkında ipucu verebilir. Alerjik rinit tanısı almış bir hastada nazal steroid kullanım öyküsü ile septum deviasyonu tanısı sonrasında önerilmiş operasyon varlığıyla sorunun kaynağı belirlenebilir. Öyküde, burun tıkanıklığı ve horlama sorunu, süresi, gebelikle ilişkisi, gebelik öncesinde burun akıntısı, hapşırık, koku bozukluğu, operasyon öyküsü varlığı, kullanılan ilaçlar bize rinolojik semptomların etiyolojisinde anlamlı ipuçları verebilir. Sonuç olarak, gebelik öncesinde rinolojik sorunlar için tedavi planlanması, hastanın eğitilmesi ve bilgilendirilmesi rahat bir gebelik sürecinde olası rinolojik sorunların çözümü için anlamlı katkı sağlamaktadır.Anahtar kelimeler: Gebelik, rinolojik sorunlar, tanı ve tedavi ABSTRACT Gestational period which lasts approximately 40 weeks harbours physiological and hormonal alterations. Nasal congestion and symptoms of rhinitis are the primary problems that affect pregnant woman's quality of life and sleep pattern adversely. Rhinologic problems are characterized by nasal congestion and nasal drip that are diagnosed preconception (septum deviation, allergic rhinitis etc.) or become evident during pregnancy (pregnancy rhinitis, rhinosinusitis etc). In fact, a carefully taken history may give us some clues about the duration and severity of the problem. In a patient who was diagnosed with allergic rhinitis the source of the problem can be identified through a history of nasal steroid usage and the operation recommended after septum deviation was diagnosed.Consequently, planning therapy for the preconception rhinologic problems, training and informing the patient will make important contributions to the resolution of rhinologic problems in a comfortable gestation process. Araşt. Hast. Dergisi 2017; 27(1):13-19 doi:10.5222/terh.2017.013 Gİrİş Gebelik, doğal bir süreç olarak görülmesine rağ-men, anne adayını bedensel, ruhsal, biyolojik ve fizyolojik olarak etkilendiği karışık bir süreçtir. Temelde kulak-burun-boğazla ilgili yakınma ve bulgular, gebeliğin fizyolojik ve hormonal (östrojen ve progesteron seviyeleri) süreciyle yakından ilişkilidir. Rinolojik sorunlar genelde burun tıkanıklığı, burun akıntısı, burun kanaması şeklinde sıralanmaktadır. Key words: Pregnancy, rhinologic problems, diagnosis and treatment

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Epistaxis in pregnancy – not to be sniffed at!

Cited by 8 publications

References 7 publications

ENT Changes of Pregnancy and Its Management

ENT Changes of Pregnancy and Its Management

Torrential epistaxis in the third trimester: a management conundrum

The most frequently encountered rhinologic problems during pregnancy: appropriate approaches toward diagnose and therapy.

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