Pain in the ear in pregnancy

Pain in the ear during pregnancy can be for various reasons - and most importantly to exclude the infectious process that threatens the mother and child. Do not panic immediately if you have this symptom. It is necessary to understand the cause, and then begin to treat.

[1], [2], [3], [4]

Causes of the pain in the ear in pregnancy

Any infectious disease in pregnant women is a problem. Since you can not have proper treatment and take all the necessary medications, while the harm from bacteria and viruses is significant, you should think in advance about the prevention of ENT diseases and other diseases during pregnancy. Unfortunately, not everyone can avoid such diseases. Ear infection is one of the most common pathologies that many women face during pregnancy.

Pain in the ear is one of the most intense. There may be sharp, pounding pains or dull pain that spreads to the head and sinuses. Pain can be experienced in one or both ears, sometimes develop into a chronic condition and can be caused by an infection, an extraneous object, an insect that settles in the ear.

If you are prone to ear infections during pregnancy, they should be treated with caution. During pregnancy, there are a number of causes of earaches. Pain in the ear can develop due to a fungal infection, sulfur plug or due to pressure created during rest.

Ear infection develops when certain bacteria or virus attack the middle ear located behind the tympanic membrane. This leads to the formation of fluid and inflammation of the middle ear, causing severe pain. Infections can be acute or chronic. Acute infections are painful, but remain only for a short period. Chronic infections are repeated and can lead to permanent damage to the inner and middle ear. Many factors can cause ear infections.

Causes of ear inflammation are pathogens, such as bacteria or a virus that enter the ear. Inflammation leads to blockage in eustachian tubes (a tube that connects the middle ear and pharynx). This blockage causes accumulation of fluid in the middle ear, which leads to infection. In some cases, this can lead to temporary hearing loss.

If a woman has chronic ear infections, then she will have a greater risk of ear infection during pregnancy.

The pathogenesis of the development of symptoms and the intensity of pain depends on the localization of the process. Otitis is an inflammation of the ear, which can have a different shape depending on the localization of inflammatory changes. The ear consists of external, middle, internal parts. The names of ear infections expire from the names of the ear parts: external otitis media, otitis media and otitis inner (labyrinthite). External otitis is characterized by inflammation of the auditory canal, auricle and tympanic membrane. Otitis affects mainly the mucosa of the tympanic membrane and the auditory tube. The middle ear consists of mastoid cells and the temporal bone. If the disease spreads in this area, it is believed that otitis is complicated by mastoiditis.

The most serious disease is labyrinthitis, or otitis internal. The inner ear in addition to the snail (sound analyzer) includes the vestibular receptor, so such otitis during pregnancy can provoke vestibular failures and affect the auditory function. External otitis is considered the safest in terms of consequences, while most often pregnant women suffer from catarrhal otitis media and purulent otitis media.

[5], [6], [7], [8], [9]

Risk factors

Risk factors for ear pain in pregnancy are in pregnancy itself, which reduces the ability of the female body to fight many bacteria and viruses. In most cases, otitis is caused by reduced immunity in a pregnant woman, as the body becomes more vulnerable to infections. As a result, the slightest cooling of the head or ear contributes to the development of the first symptoms of the disease, as the bacteria begin to multiply in the outer and middle ear.

Viral infections can also contribute to the development of otitis in pregnancy. If you are prone to ear pathologies, you may experience unpleasant otitis due to ARVI. The outbreak of other chronic diseases such as sinusitis, tonsillitis, rhinitis, can have the same effects, because all these organs are interconnected, and the infection can move freely from the nasopharynx, nose and throat to the ear through the ear tube. If a woman has problems such as a diverted septum, hypertrophy of nasal tonsils or polyps, somatic diseases, the risk of developing otitis during pregnancy will be even higher.

Pain in the ear can be caused due to irritation with water, the so-called secondary otitis media.

This is an infection that occurs in the canal between the outer ear and the tympanic membrane. Although this infection can be caused in many ways, it mainly occurs when water enters the ears during bathing. It may also be associated with an infected hair follicle in the ear or a sharp ear cleaning. A clogged auditory can lead to severe pain and a feeling of ear congestion.

Another common and simple reason for pain in the ear during pregnancy is the sulfur plug. Usually, the air pressure inside the ear and outside is the same. But many reasons can block the Eustachian tube that connects the middle ear with the back of the nasal passage and throat. When this happens, the Eustachian tube is not able to maintain the correct equal air pressure. This causes pain in the ear. When pregnancy under the influence of hormones, ear wax synthesis can increase, so pregnant women face this problem more often. Usually during air flights, at high altitudes or under water, when there is a constant pressure of outside air, there is usually a pressure jump in the ears. This can also be the cause of earaches.

[10], [11], [12], [13], [14], [15]

Epidemiology

Statistics of the spread of pain in the ear in pregnancy indicate a high incidence of this pathology. Every tenth pregnant woman can experience this feeling, and more than 78% of cases are an inflammatory process. Otitis, or ear infections, is one of the most common childhood illnesses, but it less often affects adults, especially pregnant women due to the characteristics of the immune system. The frequency of complications is very low, but, nevertheless, the process itself can be very troubling to the expectant mother.

[16], [17], [18], [19], [20], [21], [22], [23], [24]

Symptoms

Symptoms of otitis in pregnant women can be manifested not only by pain in the ear. Most pregnant women with otitis have the following symptoms:

• feeling of pressure in one or both ears;
• noise in the head;
• itching, irritation in the ear canal;
• leakage of fluid from the ear;
• hearing impairment;
• general malaise;
• increased body temperature;
• lymphadenitis.

The first signs of the inflammatory process in the ear may be manifested by an increase in body temperature, and then only pain may appear. This may indicate infection.

There are different types of otitis for localization - it's external, internal and average. Also distinguished by the degree of the inflammatory process is catarrhal, purulent and gangrenous. Such types of otitis can be considered as stages in the development of the process, since if one species is not treated, it can go on to the next type of inflammation.

Typically, the initial stage of otitis media is characterized by severe pain when turning the head or in a calm state. After a few days without adequate therapy, this otitis grows to a purulent form. The drum cavity, filled with purulent fluid, puts pressure on the tympanic membrane, which finally collapses. After that, the pain decreases, and the ear canal is filled with pus, and sometimes with blood. The perforation of the tympanic membrane gradually heals, the hearing improves or is completely restored.

But such symptoms can vary in pregnant women. Most often, at first otitis has a suppressed form, but sometimes it develops quickly accompanied by a malaise, but does not show any local symptoms. In some cases, a pregnant woman with damage to the ear can have normal body temperature and feels well.

Pain in the ear during pregnancy in the first trimester is more likely due to infection, because during this period the woman's immune system adapts to the child, and she is slightly weakened. When the pain in the ear during pregnancy occurs in the 2nd and 3rd trimester, it can be an ear plug. At the same time, a woman can feel ear congestion, slight tingling, and pain is less intense than with otitis media. You also need to remember if the pregnant woman has been swimming recently in the pool, which can also cause such a symptom.

Sometimes it happens that the ear blew during pregnancy. This concept is folk, but it covers exactly those cases when otitis occurs at low ambient temperature. Reheating on the street can change the pressure in the ear, which in turn disrupts the flow of air, which can be a risk factor for stagnant bacteria in the ear. This is how otitis develops.

The consequences and complications of the disease on the fetus are clear: all viral infections have negative consequences, while some of them are able to penetrate the placental barrier, interfering with normal development, and cause hypoxia. Infectious diseases can provoke miscarriage, premature birth and cause other problems. Fortunately, if a pregnant woman comes to the doctor at an early stage, the disease will not spread to the areas of other organs and will not cause any complications, as she will stop at the local level. Otitis can harm both the baby and the expectant mother. Without adequate therapy, it often becomes chronic, and regular outbreaks lead to hearing loss.

Diagnostics of the pain in the ear in pregnancy

Diagnosis of otitis media in pregnant women includes otoscopy, microbiological examination of the ear smear. If necessary, women are assigned hearing tests (a test for a camera or audiometry), testing of auditory tube function, endoscopic examination of the nasopharynx. Radiography and CT in pregnant women are strictly prohibited, and if a woman is urgently needed, an MRI can be prescribed starting from the second trimester of pregnancy. A simple history can lead to the idea of a diagnosis. But to determine the participation of otitis media and visualization, it is necessary to examine the tympanic membrane, which is necessary for the diagnosis. This is usually done with a pneumatic otoscope attached to a rubber bulb, which helps to see the tympanic membrane and assess its mobility.

Otoscopy is a study that involves studying the ear with an instrument called the otoscope (or auriccope). This is done in order to examine the external auditory canal - a tunnel that leads from the outer ear to the eardrum.

The examination of the eardrum can also provide a lot of information about what is happening in the middle ear - the space inside the skull where the mechanisms of hearing and balance are located.

Before inserting the cone of the otoscope into the ear canal, the outer ear is checked for signs of disease that may be related to the patient's symptoms. So you can eliminate the plug, which can also cause earache in pregnant women. Examination of the external auditory canal is performed carefully, pulling the outer ear part up and back. This action straightens the external auditory canal, which has a natural curve and makes it easier to view the eardrum.

A normal external auditory canal has some hair, often lined with yellow-brown wax. The total length of the ear canal in adults is approximately 2 cm.

The normal eardrum looks pinkish-gray in color and has an approximately circular shape. Most otoscopes have a small connection to the vent, which allows the doctor to blow air into the canal. Watching how many tympanum moves with air pressure, its mobility is estimated, which depends on the pressure inside the middle ear. This method is called insufflation. Usually the air pressure in the middle ear is the same as in the outer ear. This allows the tympanic membrane to lie in the middle position and most effectively respond to sound vibration. When the Eustachian tube is blocked, the tympanic membrane remains stationary.

Changes in the tympanic membrane with acute otitis depends on the time of infection. As a rule, the tympanic membrane becomes red or yellow in appearance and opaque with indistinct landmarks - it may seem convex. Insufflation can demonstrate a decrease in mobility.

Sometimes in acute otitis media, the tympanic membrane will burst, allowing the pressure (and pain) to be reduced. Then you can often see slime, as well as unloading in the outer ear.

Signs of otitis media with a visual examination of the membrane include: filling, cloudiness, redness (erythema). Sometimes it is difficult to confirm the diagnosis with a visual examination of the tympanic membrane. This can happen because the ear canal is very small, making it difficult to get a clear view. Earwax can also interfere with presentation through the ear canal, and if so, it can be removed with blunt cerurents or a wire loop.

[25], [26], [27], [28], [29], [30], [31], [32]

Differential diagnosis

Differential diagnosis should be conducted between different types of otitis media. The two most common types are acute otitis media and otitis media with effusion. It is important to distinguish them during the diagnosis, since the treatment is significantly different, especially with regard to the use of antibiotics. It is also necessary to differentiate the pain in the ear caused by inflammation and the pain caused by earwax. This can easily be diagnosed even against the background of the presence of a temperature response in ear infection.

[33], [34], [35]

Treatment of the pain in the ear in pregnancy

When choosing a treatment for a pregnant woman, the doctor should remember that the benefits of using drugs should be greater than the potential danger. In other words, the fetus should not be exposed to excessive risk - otitis during pregnancy should be treated with the safest means. In the initial catarrhal stage of otitis, when the tympanic membrane is not yet perforated, and there is no pus, you may be prescribed local anti-inflammatory ear drops, such as Otipax or Otinum.

1. The otinum during pregnancy can be used as a pathogenetic therapy. The composition of the drug includes a derivative of salicylic acid - choline. The drug has an anti-inflammatory effect, reduces the severity of pain and reduces swelling. The method of application - in the form of drops of the ear locally in a warm form. Dosage is two drops four times a day in both ears, even if only one hurts. The drug is not absorbed into the blood and does not show systemic influence. But there may be side reactions in the form of local tingling, burning, and allergic reactions. Precautions - although the medicine does not have a systemic effect, however, in pregnancy, use with caution, without exceeding the dose.
2. Otipax during pregnancy is also a common treatment for otitis media. The composition of the drug includes phenazone and lidocaine. Phenazone has an anti-inflammatory property and anti-edema, reduces irritation in otitis media. Due to the content of lidocaine, pain decreases and anxiety decreases. The way of using the drug is to use it in the form of drops in each ear. Dosage - four drops three times a day. Side effects are infrequent, since the drug is not absorbed when the tympanic membrane is intact. In pregnancy, you can use for local treatment of otitis or to treat pain after ear plugs.
3. Boric alcohol during pregnancy can be used if the pain in the ear is caused by the formation of sulfuric cork. In such cases, the use of boric alcohol is considered the best tool. Due to its light alcohol properties, the drug cleaves the bonds between the sulfur cork molecules, which allows it to dissolve. The method of application of the drug is as follows: it is necessary to heat the alcohol to room temperature, moisten the turunda in alcohol and mark it in the ear for ten minutes. This may feel a slight tingling or tingling, which is considered normal. In ten minutes you need to take out the turunda, and you will feel how it becomes wet in the ear. After this, you need to gently clean the external ear canal with a stick.

On the advice of your doctor, you can insert into the ear heating turuns, impregnated with alcohol, to reduce inflammation. In the case of suppurative external otitis, pus is removed and the ear is disinfected with antiseptics suitable for pregnant women (for example, Miramistin). In the case of severe swelling of the auditory tube, vasoconstrictor drops should be used in doses of children (Nazivin, Simelin). If the inflammation of the external ear can turn into otitis media, you can prescribe local antibiotic drops (Sofradex, Sulfaсyl sodium). You can also prescribe penicillin antibiotics, such as Amoxicillin, Flemoxin. If you have a lot of pus, the doctor in his office will pierce the eardrum and disinfect the outer ear with alcohol, hydrogen peroxide or an antiseptic. Blowing out the auditory tube, pneumomassage of the tympanic membrane for 7-14 days also helps and it is absolutely safe for both the woman and the fetus.

Folk treatment of pain in the ear

You can supplement the traditional therapy prescribed by your otolaryngologist with effective folk remedies. Any folk medication should be used only after diagnosis and get your doctor's approval. It is strictly forbidden to warm your ear or make compresses before you see your doctor, because in the case of purulent otitis this can lead to serious complications. Some drugs at the perforation stage can cause big problems if they get into the inner ear. Therefore, traditional medicine must be used with caution.

Folk methods that use the following:

1. Both apple cider vinegar and white vinegar are known to be good fighters for all kinds of mushrooms. Vinegar works with a fungal infection and removes it during drainage. Take one teaspoon of each vinegar and water and mix well.

Lie on your side so that the infected ear is on top. Now soak the cotton turunda in the mixture and put it on the infected ear. Hold such a compress for about 15 minutes, and then remove the liquid by turning the head in the opposite direction. Completely dry your ear. If you do this twice a day, you will get rid of the infection within 2 or 3 days.

2. Ear pain, if blown, can be removed by putting a warm salt bag or a bottle of warm water on the infected ear. It works like a hot compress. But you can not make such a compress if there is pus or you have not yet consulted a doctor and do not know if there is pus there. To put a salt bag, take 100 g of salt in a saucepan and heat it. Seal the salt in a clean cotton cloth and make a bag of it. Place the bag in your ear and hold it until the heat is lost. This also reduces the feeling of pressure on the ear.
3. Garlic has antibacterial properties that can reflect ear infection. Place three drops of garlic oil in the infected ear using a pipette. Garlic extract is a safe home remedy, but when the amount or severity of the infection is unknown, there is no clear indication that a home remedy will eliminate this infection.
4. Place two drops of olive or mineral oil in the infected ear. The oil breaks the blocked wax, which then quickly exits the ear. If you continue to experience pain, and the wax is too difficult to quickly soften, you should consult a doctor.
5. Use hydrogen peroxide in the ear to relieve ear pain. Place 2 to 3 drops in the ear while lying with the affected ear up. Stay in this position for about 10 minutes and you should feel relieved.

Herbal treatment can also be used.

1. Boil in 300 ml of water a bag of thin cut bay leaf for 10 minutes. Leave the infusion for two hours, then pour out the sheets from the infusion. Apply infusion on turundum and apply a few drops to rinse your ear.
2. Take a fresh sheet of geranium, rinse it, roll it into the tube and insert into the ear. Keep geranium in your ear for 1-2 hours. Such a dry compress will relieve inflammation and pain.
3. Make a tincture of propolis (1 part) and vegetable oil (2 parts). Apply 5 drops of solution to each ear, cover the ears with cotton and leave the medicine in the auditory canal for 15 minutes.

Surgical treatment is the last and rare option that doctors choose. If the ear infection does not disappear, the doctor may need to perform an operation to evacuate fluid from the middle ear. He will insert the tubes into his ear to allow the excess fluid to flow out. Removing the fluid will help you hear better, and alleviate many of the associated symptoms. Surgery is also an option if the adenoids become extremely large and cause earache and inflammation.

[36], [37], [38]

Prevention

Preventive maintenance of pain in the ears should begin with elementary measures, which exclude the ingress of foreign bodies into the auditory canal. Do not completely immerse in water while swimming, so that water does not get into your ears, as water can be a source of infection. Try to keep your head above the water level. When swimming, use earplugs. Avoid scratching your ears and injuries while cleaning your ear canal. Tilt your head when you exit the pool to wipe the remaining water. Dry your ears with a dry towel or hair dryer immediately after bathing. Since otitis often results from a viral infection or hypothermia to prevent it, you need to avoid flu and colds, dress in the weather and cover your head during the cold season. Even before pregnancy, you must strengthen immunity, which requires more walking, proper eating, training and protection against colds. Taking a bath or shower, avoid penetration of water into the ear canal, as this helps to reduce local immunity and often causes otitis media.

[39], [40], [41], [42], [43]

Forecast

The prognosis of ear pain during pregnancy is favorable for the child, even if there is an infection. While the infection in the ear does not go into the bloodstream, it will not affect your unborn baby. You can take medicines to treat infections that are safe and resolved during this period.

Pain in the ear during pregnancy is not always a sign of otitis, sometimes it is just a manifestation of a violation of the passage of the auditory tube or a complication after swimming in the pool. In any case, a doctor's consultation is needed to avoid complications. But even if there is an infection in the ear, there are medications that are allowed during pregnancy and will not harm your baby.

[44], [45], [46], [47]