ENT Diseases: Diagnosis and Treatment during Pregnancy and Lactation

Preface
Preface
Contents
List of Contributors
Part I: Physiological Changes During Pregnancy and the Postpartum Period
1: Maternal Physiology During Pregnancy
1.1 Introduction
1.2 Hematological Changes
1.2.1 Blood Volume
1.2.2 Red Blood Cells
1.2.3 Iron Supplementation
1.2.4 Immunological Changes
1.2.5 White Blood Cells and Inflammatory Markers
1.2.6 Coagulation and Fibrinolysis
1.3 Cardiovascular System Changes
1.4 Endocrine System Changes
1.5 Metabolic Changes
1.5.1 Glucose Metabolism
1.5.2 Lipid Metabolism
1.5.3 Protein Metabolism
1.6 Ear, Nose, and Throat Changes
1.6.1 Ear Changes
1.6.2 Nasal Changes
1.6.3 Throat Changes
1.7 Respiratory System Changes
1.8 Gastrointestinal System Changes
1.8.1 Oral Cavity
1.8.2 Gastrointestinal Tract
1.8.3 Liver
1.8.4 Gallbladder
1.9 Renal System Changes
1.10 Reproductive Tract Changes
1.11 Mammary Tissue Changes
1.12 Musculoskeletal Changes
1.13 Skin Changes
References
2: Physiological Changes During the Postpartum Period: General Overview
2.1 Introduction
2.2 Physiological Changes During the Postpartum Period
2.2.1 Physiological Changes in the Organs of Reproduction and the Perineum
2.2.1.1 Uterus
2.2.1.2 Cervix
2.2.1.3 Vagina
2.2.1.4 Ovaries
2.2.1.5 Perineum
2.2.2 Physiological Adaptation in the Reproductory System
2.2.3 Physiological Changes in Breasts
2.2.4 Physiological Changes: Lactation
2.3 Physiological Changes in the Endocrine System
2.4 Physiological Changes in Fluid Balance
2.5 Physiological Changes in the Haematological System
2.6 Physiological Changes in the Cardiovascular System
References
3: Immune System and Pregnancy
3.1 Introduction
3.2 Endometrium and Menstrual Cycle
3.3 Fertilization and Blastocyst Formation
3.4 Implantation of Blastocyst
3.4.1 Apposition
3.4.2 Adhesion/Attachment
3.4.3 Invasion/Penetration
3.4.4 Placentation
3.4.5 Decidualization and Immune Regulation
3.5 Hormonal Factors in the Implantation
3.6 Cytokines in the Implantation
3.7 The Composition of Immune Cells in Decidua
3.8 Microbiota
3.9 Delivery
3.10 Conclusions
References
4: Diagnostic Imaging of the Head and Neck During Pregnancy and the Postpartum Period
4.1 Introduction
4.2 Ultrasonography
4.3 Magnetic Resonance Imaging
4.4 Ionizing Radiation
4.5 Computed Tomography and Angiography
4.6 Nuclear Medicine
4.7 Use of Contrast Media During Pregnancy and Lactation
References
5: Treatment of Respiratory Infections in Pregnant Patients: Overview
5.1 Introduction
5.2 FDA Pregnancy Categories
5.3 Current FDA Classification Scheme
5.3.1 Category A
5.3.2 Category B
5.3.3 Category C
5.3.4 Category D
5.3.5 Category X
5.4 Antibiotic Groups
5.4.1 Penicillins
5.4.2 Cephalosporins and Cephamycins
5.4.3 Carbapenems
5.4.4 Glycopeptides and Lipoglycopeptides
5.4.5 Macrolides and Ketolides
5.4.6 Fluoroquinolones
5.4.7 Miscellaneous Antibiotics
5.4.7.1 Clindamycin
5.4.7.2 Metronidazole
References
6: The Variations in Communication During Pregnancy and the Postpartum Period
6.1 Introduction
6.2 Birth and Communication
6.3 Communication with Women and Healthcare Providers at Birth and Postpartum
6.4 Communication with Disabled Women Giving Birth
References
7: Effect of Pregnancy on the Upper Respiratory Tract and Chest Wall
7.1 Introduction
7.2 Upper Airway Changes in Pregnancy
7.2.1 Nasal Physiological Changes
7.3 Lung and Chest Wall Mechanics in Pregnancy
7.4 Respiratory Muscle Function
7.5 Effect of Pregnancy on Ventilation and Gas Exchange
References
Part II: General Otolaryngology During Pregnancy and the Postpartum Period
8: ENT Emergencies During Pregnancy
8.1 Introduction
8.2 Epistaxis
8.2.1 Treatment
8.3 Bell’s Palsy
8.3.1 Epidemiology
8.3.2 Physiopathology
8.3.3 Diagnosis
8.3.4 Treatment
8.4 Sudden Sensorineural Hearing Loss
8.4.1 Treatments
8.5 Maxillofacial Trauma
8.6 Deep Neck Infections
References
9: Postpartum ENT Emergencies
9.1 Introduction
9.2 Postpartum Thyroiditis
9.3 Epistaxis
9.4 Hereditary Angioedema
9.5 Vertigo
9.6 Laryngeal Oedema
9.7 Bell’s Palsy
References
10: Use of Antibiotics During Pregnancy and the Postpartum Period
10.1 Introduction
10.2 Drug Absorption
10.3 Drug Distribution
10.4 Drug Metabolism
10.5 Drug Excretion
10.5.1 Penicillins
10.5.2 Cephalosporins
10.5.3 Carbapenems
10.5.4 Fluoroquinolones
10.5.5 Macrolides
10.5.6 Aminoglycosides
10.5.7 Sulfonamides and Trimethoprim
10.5.8 Tetracyclines
10.5.9 Azteronam
10.5.10 Lincosamides
10.5.11 Linezolid
10.5.12 Metronidazole
10.5.13 Nitrofurantoin
10.5.14 Rifampicin
10.5.15 Vancomycin
References
11: Use of Corticosteroid During Pregnancy and the Postpartum Period
11.1 Introduction
11.2 Corticosteroid and Pregnancy
11.3 Corticosteroid and Lactation
11.4 Conclusion
References
12: Use of Topical Therapies During Pregnancy and the Postpartum Period
12.1 Introduction
12.2 Topical Ear Drugs (Or Drops)?
12.2.1 Antibiotics
12.2.2 Glucocorticoids
12.2.3 Antiseptics and Acidifying Solutions
12.3 Topical Nasal Drugs
12.3.1 Intranasal Corticosteroid
12.3.2 Intranasal Decongestants
12.3.3 Intranasal Antihistamines
12.3.4 Saline Lavages
12.4 Other Topical Drugs
References
13: Locoregional Anaesthesia During Pregnancy and the Post-partum Period
13.1 Introduction
13.2 The Anatomy and Techniques for Nerve Blocks of the Head and Neck
13.2.1 Trigeminal Nerve
13.2.1.1 Trigeminal Nerve Blocks
13.2.1.2 The Trigeminal Cardiac Reflex
13.2.2 Ophthalmic Nerve
13.2.3 Supraorbital and Supratrochlear Nerves
13.2.3.1 Supraorbital and Supratrochlear Nerve Blocks
13.2.4 Nasociliary Nerve
13.2.4.1 Nasociliary Nerve Block
13.2.5 Maxillary Nerve
13.2.5.1 Maxillary Nerve Block
Suprazygomatic Approach
Greater Palatine Canal Approach
Coronoid Approach
13.2.6 Infraorbital Nerve
13.2.6.1 Infraorbital Nerve Block
Intraoral Approach
Extraoral Approach
13.2.7 Zygomaticotemporal Nerve
13.2.7.1 Zygomaticotemporal Nerve Block
13.2.8 Zygomaticofacial Nerve
13.2.8.1 Zygomaticofacial Nerve Block
13.2.9 Mandibular Nerve
13.2.9.1 Mandibular Nerve Block
Gow-Gates Technique
Vazirani-Akinosi Closed-Mouth Technique
Coronoid Approach
13.2.10 Mental Nerve
13.2.10.1 Mental Nerve Block
13.2.11 Auriculotemporal Nerve
13.2.11.1 Auriculotemporal Nerve Block
13.2.12 Sphenopalatine Ganglion
13.2.12.1 Pterygopalatine Ganglion Block
Topical Application Approach
13.2.13 Cervical Plexus
13.2.13.1 Cervical Plexus Block
13.2.13.2 Greater Auricular Nerve Block
13.2.13.3 Greater Occipital and Lesser Occipital Nerve Blocks
13.3 The Anatomy and Techniques for Regional Blocks of the Head and Neck
13.3.1 Regional Anaesthesia of the Ear
13.3.1.1 Block Technique
13.3.2 Regional Anaesthesia of the Nose
13.3.2.1 Block Technique
13.3.3 Regional Anaesthesia of the Scalp
13.3.3.1 Block Technique
13.3.4 Regional Anaesthesia of the Upper Airway
13.3.4.1 Trigeminal Nerve
13.3.4.2 Glossopharyngeal Nerve
Glossopharyngeal Nerve Block
13.3.4.3 Vagal Nerve
Superior Laryngeal Nerve Block
Recurrent Laryngeal Nerve Block
13.4 Local Anaesthetics
13.5 LAST Treatment
References
14: General Anesthesia During Pregnancy and the Postpartum Period
14.1 Introduction
14.1.1 Anesthetic Considerations for Nonobstetric Surgery During Pregnancy
14.1.2 Timing of Surgery
14.2 Maternal and Fetal Safety
14.2.1 Maternal Safety
14.2.1.1 Maternal Physiology and Anesthetic Implications
Changes in the Cardiovascular System
Supine Hypotensive Syndrome
Changes in the Respiratory System
Changes in the Gastrointestinal System
Other Changes
14.2.2 Fetal Safety
14.2.2.1 Fetal Effects of Anesthesia
14.2.2.2 Fetal Effects of Maternal Factors
14.2.2.3 Placental Transfer of Drugs
14.2.2.4 Teratogenicity
14.2.2.5 Risk Categorization of Drugs
14.2.2.6 Fetal Heart Rate Monitoring
14.2.2.7 Avoidance and Treatment of Preterm Delivery
14.3 Anesthetic Drugs
14.3.1 Frequently Used Drugs for Anesthesia and Analgesia
14.3.1.1 Benzodiazepines
14.3.1.2 Opioids
14.3.1.3 Hypnotics
14.3.1.4 Volatile Anesthetics
14.3.1.5 Neuromuscular Blockers
14.3.1.6 Neuromuscular Block Reversal Agents
14.3.1.7 Anticholinergic Drugs
14.3.1.8 Nonopioid Analgesics
14.4 Anesthesia Management
14.4.1 General Anesthesia
14.4.1.1 Preanesthetic Evaluation
14.4.1.2 Rapid Sequence Induction and Intubation
14.4.1.3 Difficult Airway Management
Cannot Intubate–Cannot Ventilate
14.5 Anesthesia and Postoperative Analgesia in Lactation
14.6 Cardiopulmonary Resuscitation in Pregnancy
14.6.1 Differences in Basic Life Support and Advanced Cardiovascular Life Support in Pregnant Women
14.6.1.1 Basic Life Support
14.6.1.2 Circulation
14.6.1.3 Airway
14.6.1.4 Perimortem Cesarean Delivery
14.6.1.5 Drugs Used During Advanced Cardiovascular Life Support
References
15: Pain Management in Pregnancy and Lactation
15.1 Introduction
15.2 Physiological Changes in Pregnancy
15.2.1 Hormonal Changes
15.2.2 Cardiovascular and Hemodynamic Changes
15.2.3 Respiratory Changes
15.2.4 Hematological Changes
15.2.5 Renal Changes
15.2.6 Gastrointestinal Changes
15.2.7 Musculoskeletal Changes
15.3 Pharmacokinetic Mechanisms in Pregnancy
15.4 Placental Transfer of Drugs
15.5 Nonobstetric Pain Situations in Pregnancy
15.6 Pharmacological Pain Treatment in Pregnancy and Lactation
15.6.1 Medication in Pregnancy
15.7 Medications in the Breastfeeding Mother
15.7.1 Drug Delivery Route
15.7.2 Pharmacokinetic Properties of the Drug
15.8 Infant-Related Features
15.9 Factors Determining the Effect of Drugs on Infants
15.10 Frequently Used Drugs for Pain Management
15.10.1 Acetaminophen
15.10.2 Nonsteroid Anti-inflammatory Drugs (NSAIDs)
15.10.3 Opioid Analgesia
15.11 Local Anesthetics
15.11.1 Glucocorticoids
15.12 Anticonvulsants
15.12.1 Pregabaline–Gabapentine
15.12.2 Topiramat
15.12.3 Carbamazepine
15.12.4 Antidepressants
15.12.5 Triptanes and Ergot Alkaloids
15.12.6 Neuroleptics (Dopamine Antagonists)
15.12.7 Muscle Relaxants
15.12.8 Interventional Analgesics in Pregnancy and Lactation
15.13 Physical Therapy
15.14 Acupuncture
15.15 Botulinum Toxin
References
16: Oral Mucosal Lesions During Pregnancy and in the Postpartum Period
16.1 Introduction
16.2 Anatomy of the Oral Cavity
16.3 Structure and Function of the Oral Mucosa
16.4 Oral Mucosal Lesions During Pregnancy
16.4.1 Oral Candidiasis
16.4.2 Pregnancy Gingivitis
16.4.3 Pyogenic Granuloma
16.4.4 Morsicatio Buccarum
16.4.5 Benign Migratory Glossitis
16.4.6 Aphthous Ulcers
16.4.7 Behcet’s Disease
16.4.8 Pemphigus Vulgaris
16.4.9 Gestational Pemphigoid
References
17: Snoring and Sleep Apnea During Pregnancy and Postpartum Period
17.1 Introduction
17.2 Sleep Disorders and Pregnancy
17.3 Physiological Changes in Pregnancy
17.3.1 Factors that Prevent SDB During Pregnancy
17.3.2 Factors that Facilitate SDB During Pregnancy
17.4 Snoring in Pregnancy
17.4.1 Epidemiology and Risk Factors
17.4.2 Maternal Morbidity
17.4.2.1 Hypertension and Preeclampsia
17.4.2.2 Diabetes
17.4.2.3 Depression
17.4.2.4 Obstetrical Outcomes
17.5 Fetal/Infantile Morbidity
17.5.1 Infant Birth Weight
17.5.2 SGA/Intrauterine Growth Retardation
17.5.3 Preterm Delivery
17.5.4 Cesarian Section
17.5.5 APGAR
17.5.6 Genetic Disorder
17.5.7 Treatment
17.6 Sleep Apnea in Pregnancy
17.6.1 Epidemiology and Risk Factors
17.6.2 Symptoms
17.6.3 Screening and Diagnosis
17.6.4 Maternal Morbidity
17.6.5 Neonatal Morbidity
17.6.6 Treatment
17.7 Postpartum Period
References
18: Dysphagia During Pregnancy and the Postpartum Period
18.1 Introduction
18.2 Initial Approach to a Patient with Dysphagia
18.3 General Considerations About Dysphagia in Pregnancy and Postpartum Period
18.4 Considerations About some Specific Causes of Dysphagia in Pregnancy and Postpartum Period
18.4.1 Achalasia
18.4.2 Other Motility Disorders
18.4.3 Esophageal Tumors
18.4.4 Gastroesophageal Reflux Disease, Peptic Stricture, and Schatzki’s Ring
18.4.5 Other Benign Strictures
18.4.6 Eosinophilic Esophagitis
18.4.7 Functional Dysphagia
18.4.8 Neurological Disorders
References
19: Temporomandibular Joint Disorders During Pregnancy and the Postpartum Period
19.1 Introduction
19.2 Signs and Symptoms of Temporomandibular Disorders
19.3 Etiology
19.4 Diagnosis
19.5 TMD in Relation to Pregnancy/Lactation
19.6 Treatment
19.7 Conclusion
References
20: Odontogenic Diseases During Pregnancy and Postpartum Period
20.1 Introduction
20.2 Stomatologic Changes Due to Alterations of Pregnancy
20.2.1 Changes in Oral Mucosa
20.2.2 Changes in Oral Microbiota
20.2.3 Changes in Saliva
20.3 Odontogenic and Stomatologic Diseases of Pregnancy
20.3.1 Gingivitis Gravidarum
20.3.2 Epulis Gravidarum (Pregnancy Tumor)
20.3.3 Dental Erosion
20.3.4 Odontogenic Inflammatory Lesions
20.3.5 Caries in Pregnancy
20.3.6 Dental Abscesses in Pregnancy
20.3.7 Odontogenic Inflammatory Cysts in Pregnancy
20.4 Alterations in Preexisting Diseases with Oral Manifestations During Pregnancy
20.4.1 Odontogenic Tumors
20.4.1.1 Ameloblastoma
20.4.1.2 Adenomatoid Odontogenic Tumor
20.4.2 Temporomandibular Disorders
20.5 Effects of Odontogenic and Stomatologic Diseases on Systemic Conditions
20.6 The Postpartum Period
References
21: Tonsillopharyngitis During Pregnancy and the Postpartum Period
21.1 Introduction
21.2 Tonsillopharyngitis
21.3 Etiology
21.4 Signs and Symptoms
21.5 Antibiotics in Pregnancy
21.5.1 Classification
21.5.2 Antibiotics in Frequent Use
21.6 Antibiotic Use During Breastfeeding
21.6.1 Milk-to-Plasma Ratio
21.6.2 Excretion of Antibiotics in Breast Milk
21.6.2.1 Penicillins
21.6.2.2 Clavulanic Acid
21.6.2.3 Cephalosporins
21.6.2.4 First-Generation Cephalosporins
21.6.2.5 Second-Generation Cephalosporins
21.6.2.6 Third-Generation Cephalosporins
21.6.2.7 Metronidazole
21.6.2.8 Fluoroquinolones
21.6.2.9 Macrolides
References
22: Facial and Deep Cervical Infections During Pregnancy and the Postpartum Period
22.1 Introduction
22.2 Etiology
22.3 Microbiology
22.4 Anatomy
22.5 Clinical Assessment
22.5.1 History
22.5.2 Physical Examination
22.6 Laboratory Evaluation
22.6.1 Blood Tests
22.6.2 Imaging Studies
22.7 Treatment
22.7.1 Airway Management
22.7.2 Medical Treatment
22.7.2.1 Metabolic Support and Liquid Replacement
22.7.2.2 Antibiotic Treatment
22.7.2.3 Analgesia
22.7.3 Surgical Treatment
22.8 Complications
References
23: Influenza Occurring in Pregnant Women
23.1 Influenza Virus
23.2 Influenza in Pregnancy
23.3 Clinical and Laboratory Diagnosis
23.4 Complications
23.5 Pregnancy-Related Complications
23.6 Preterm Birth
23.7 Small-for-Gestational Age
23.8 Stillbirth
23.9 Pathophysiologic Mechanisms Underlying Increased Influenza Risk to Pregnant Women
23.10 Prevention and Treatment of Influenza in Pregnancy
23.10.1 Vaccination
23.10.2 Nonspecific Treatment
23.10.3 Antiviral Treatment
23.11 Conclusion
References
24: Management of COVID-19 During Pregnancy and the Postpartum Period
24.1 Introduction
24.2 COVID-19 in Pregnant Women
24.2.1 COVID-19 Epidemiology in Pregnant Women
24.3 SARS-CoV-2 Virus Transmission Routes During Pregnancy
24.3.1 Mother-to-Baby Transmission
24.4 Diagnosis of SARS-CoV-2 During Pregnancy
24.5 Clinical Findings in Pregnancy
24.6 Pregnancy Complications
24.6.1 Fetal Complications
24.7 Approach to Pregnant Women with Suspected or Diagnosed COVID-19
24.7.1 Monitoring at Home
24.7.2 Follow-up of Pregnant Women Diagnosed with COVID-19 in the Hospital
24.8 Treatment
24.8.1 Maternal Respiratory Support
24.8.2 Use and Type of Venous Thromboembolism Prophylaxis
24.8.3 Dexamethasone
24.8.4 Antiviral Drug Therapy
24.8.5 Convalescent Plasma
24.8.6 Low-dose Aspirin and Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
24.8.7 Tokolysis
24.9 Fetal Monitoring
24.10 Follow-up of Women Recovering from COVID-19
24.11 Planning Delivery in COVID-19 Pregnant Women
24.11.1 Analgesia and Anesthesia
24.11.2 Psychological Support
24.12 Protective Measures
24.13 Follow-up of a Newborn Born from a Mother Diagnosed with COVID-19
References
25: Head and Neck Trauma During Pregnancy and the Postpartum Period
25.1 Introduction
25.2 Pregnancy-Related Changes to be Monitored
25.3 Assessment of Trauma
25.3.1 Primary Evaluation
25.3.2 Evaluation of Foetal Condition
25.3.3 Secondary Evaluation
25.3.4 Radiological Evaluation
25.4 Choosing the Anaesthetic Method
25.4.1 General Anaesthesia (GA)
25.4.2 Local Anaesthesia (LA)
25.5 Choice of Treatment
25.5.1 Analgesics
25.5.2 Antibiotics
25.5.3 Corticosteroids
25.6 Conclusion
References
26: Head and Neck Trauma During Pregnancy and the Postpartum Period: General Overview
26.1 Introduction
26.2 Fetal and Maternal Injury Mechanisms
26.3 Blunt Abdominal Trauma
26.3.1 Protection
26.4 Penetrating Traumas
26.5 Evaluation, Diagnosis, and Treatment
26.5.1 Pre-Hospital Environment
26.5.2 First Evaluation
26.5.2.1 Airway
26.5.2.2 Breathing
26.5.2.3 Circulation
26.5.2.4 Disability
26.5.2.5 Exposure
26.5.3 Second Evaluation
26.5.3.1 Routine Laboratory Tests
26.5.3.2 Radiography
26.5.4 Ultrasonography
26.5.5 Magnetic Resonance Imaging
26.5.6 Computed Tomography Scan
26.5.7 Diagnostic Peritoneal Lavage
26.5.8 Fetomaternal Hemorrhage
26.5.9 Fetal Monitoring
26.6 Specific Maternal Injuries
26.6.1 Thermal Burns
26.6.2 Electric Injuries
26.7 Postpartum Period
References
27: The Effects of Vitamin D Deficiency and Its Replacement in the Gestation and Lactation Periods
27.1 Introduction
27.2 Background and Epidemiology
27.3 The Metabolism of Vitamin D
27.4 Measurement Methods of Vitamin D
27.5 Vitamin D Deficiency
27.6 The Maternal and Fetal Outcomes of Vitamin D Deficiency Seen During the Gestation Period
27.7 The Maternal Outcomes Seen During Pregnancy Depending Upon Vitamin D Deficiency
27.8 The Effects of Vitamin D on Fetus
27.9 Vitamin D Treatment
References
28: Reliability of Frequently Used Ear, Nose, and Throat Drugs During Pregnancy and the Postpartum Period
28.1 Introduction
28.2 Drug Groups Which are Used in Ear, Nose, and Throat Practice
28.2.1 Medical Treatment of Infections in Ear, Nose, and Throat
28.2.1.1 Antibiotics
28.2.1.2 Beta-Lactam Antibiotics and Pregnancy
28.2.1.3 Penicillin Antibiotics and Pregnancy
28.2.1.4 Cephalosporins Antibiotics and Pregnancy
28.2.1.5 Glycopeptides and Pregnancy
28.2.1.6 Fosfomycin and Pregnancy
28.2.2 Agents That Increase the Permeability of the Outer Membrane
28.2.2.1 Polymyxin and Pregnancy
28.2.3 Protein Synthesis Inhibitors and Pregnancy
28.2.3.1 Macrolide Antibiotics and Pregnancy
28.2.3.2 Clindamycin and Pregnancy
28.2.3.3 Aminoglycosides and Pregnancy
28.2.4 DNA or mRNA Synthesis Inhibitors
28.2.4.1 Quinolones and Pregnancy
28.2.5 Antiviral Treatments
28.2.5.1 Oseltamivir and Zanamivir
28.2.5.2 Amantadine and Rimantadine
28.2.5.3 Acyclovir and Valacyclovir
28.2.6 Antifungal Treatments
28.3 Rhinitis and Rhinosinusitis Treatment
28.3.1 Intranasal Corticosteroids
28.3.2 Antihistamines
28.3.3 Intranasal Antihistamines
28.3.4 Leukotriene Modifiers
28.3.5 Nasal Decongestants
28.3.6 Systemic Decongestants
28.3.7 Inhaled and Oral Preparations of Corticosteroids
28.3.8 Monoclonal Antibodies
28.3.9 Anticholinergic Agents
28.3.10 Theophylline
28.4 Meniere’s Disease Treatment
28.4.1 Antiemetics
28.5 Bell’s Palsy Treatment
28.6 Anticoagulant Medications, Epistaxis, and Treatment in Pregnancy
28.6.1 Anticoagulants
28.6.2 Oral Anticoagulants
28.6.3 Antiplatelet Drugs
28.7 Others
References
29: Herpes Simplex Viral Infections in Pregnancy
29.1 Introduction
29.2 Aetiology
29.3 Clinical Features
29.3.1 Orolabial Herpes
29.3.1.1 Primary Infection
29.3.2 Recurrences
29.3.3 Genital Herpes
29.3.3.1 Primary Infection
29.3.3.2 Recurrences
29.4 HSV During Pregnancy
29.4.1 Vertical Transmission
29.4.2 Evidence
29.4.3 Management During Pregnancy
29.4.3.1 Suppressive Therapy at 36 weeks
29.4.3.2 Topical Antivirals
29.4.4 Drug Selection, Dosage and Safety
29.5 Postpartum and Neonatal Management
References
30: Headache During Pregnancy and Lactation
30.1 Introduction
30.2 Aetiology
30.2.1 Primary Headaches
30.2.2 Migraine
30.2.3 Tension-type Headache
30.2.4 Cluster Headache
30.2.5 Secondary Headaches
30.2.6 Ischaemic Stroke
30.2.7 Subarachnoid Haemorrhage
30.2.8 Idiopathic Intracranial Hypertension
30.3 Diagnostic Evaluation
30.3.1 Women at Risk of a Severe Underlying Condition Require Thorough Assessment Without Delay
30.3.2 General Principles When Assessing a Pregnant Woman with a Headache
30.3.3 Assessment of Women During the Postpartum Interval
30.4 Treating Headaches in Patients Who Are Pregnant or Lactating
30.4.1 Acute Migraine Treatment
30.4.2 Preeclampsia
References
31: Oral Health During Pregnancy and The Lactation
31.1 Introduction
31.2 Periodontal Diseases and Adverse Pregnancy Outcomes
31.2.1 Preterm Birth (PB) and Low Birth Weight (LBW) of Neonates
31.2.2 Pregnancy Hypertension and Preeclampsia
31.2.3 Gestational Diabetes Mellitus (GDM)
31.2.4 Spontaneous Abortion (SA)
31.3 Dental Caries and Adverse Pregnancy Outcomes
31.4 Dental Management Guideline During Pregnancy
31.4.1 Emergency Treatment
31.4.2 Urgent Treatment
31.4.3 Necessary Treatment
31.4.4 Elective Treatment
31.5 Dental Treatment Timings in Pregnant Patients
31.5.1 Treatment for the First Trimester (1–12 weeks)
31.5.2 Treatment for the Second Trimester (13–24 weeks)
31.5.3 Treatment for the Third Trimester (13–24 weeks)
31.6 Dental Care and Oral Health Recommendations for Pregnant Patients
31.7 Oral Health Management
31.8 Dietary Guidelines and Food Recommendations to Provide Essential Oral Health During Pregnancy
31.9 Nicotine, Tobacco, and Alcohol Consumption During Pregnancy
31.10 Mother of Infant-Lactation Period and Breastfeeding
References
Part III: Otology, Neurotology and Skull Base Surgery During Pregnancy and the Postpartum Period
32: The Management of Hearing Loss During Pregnancy and the Postpartum Period
32.1 Introduction
32.2 Hearing Changes Due To Hormonal Changes
32.3 Otosclerosis
32.3.1 Treatment Approach
32.3.1.1 Follow-up
32.3.1.2 Amplification (Hearing Aids)
32.3.1.3 Medical Treatment
32.3.1.4 Surgical Treatment (Stapedotomy-Stapedectomy)
32.4 Sudden Hearing Loss
32.4.1 Treatment Approach
32.5 Meniere’s Disease
32.5.1 Treatment Approach
32.6 Otitis Media and External Otitis
32.6.1 Treatment Approach
References
33: Sudden Sensorineural Hearing Loss During Pregnancy and the Postpartum Period
33.1 Introduction
33.2 Audiological Findings
33.3 Etiopathogenesis
33.4 Acoustic Neurinoma
33.5 Sudden Sensorineural Hearing Loss in the Postpartum Period
33.6 Immune-Mediated Disorders
33.7 The Relationship of Sudden Sensorineural Hearing Loss and Morbidity
33.8 Treatment
33.9 Conclusion
References
34: Vestibular Disorders During Pregnancy and the Postpartum Period
34.1 Introduction
34.2 Meniere Syndrome
34.3 Benign Paroxysmal Positional Vertigo (BPPV)
34.4 Vestibular Neuritis
34.5 Migraine and Migraine-Associated Vertigo
34.6 Superior Semicircular Canal Dehiscence (SSCD)
34.7 Perilymph Fistula (PLF)
34.8 Vestibular Schwannoma (Acoustic Neuroma)
34.9 Meningioma
34.10 Otosclerosis
34.11 Conclusion
References
35: Meniere’s Disease During Pregnancy and The Postpartum Period
35.1 Introduction
35.2 Meniere’s Disease
35.2.1 Definite MD
35.2.2 Probable MD
35.3 Treatment
35.3.1 Acute Attack (Early 48 h)
35.3.2 Prevention of Attacks
35.4 Pregnancy
35.5 Postpartum Period
35.6 Treatment
References
36: Management of Chronic Otitis Media and Its Complications During Pregnancy and the Postpartum Period
36.1 Introduction
36.2 Chronic Otitis Media
36.3 Medication Classification
References
37: Otosclerosis During Pregnancy and The Postpartum Period
37.1 Introduction
37.2 Etiology
37.3 Histopathology
37.4 Symptoms, Signs, and Audiogram
37.5 Otosclerosis and Pregnancy
37.6 Treatment
37.6.1 Steps of Stapedotomy
37.7 Hearing Aids
References
38: Facial Nerve Disorders During Pregnancy and the Postpartum Period
38.1 Introduction
38.2 Epidemiology and Etiology
38.3 Clinic Course
38.4 Diagnosis
38.5 Prognosis
38.6 Treatment
38.6.1 Eye Protection
38.6.2 Corticosteroid Therapy
38.6.3 Antiviral Therapy
38.6.4 Physiotherapy
38.6.5 Surgical Treatments
38.7 Conclusions
References
39: Infections of the External Ear During Pregnancy and the Postpartum Period
39.1 Introduction
39.2 Pathophysiology
39.3 Clinical Presentation
39.4 Treatment
39.5 Complications
References
40: Acute Otitis Media and Otitis Media with Effusion During Pregnancy and the Postpartum Period
40.1 Introduction
40.2 Tympanometry
40.3 Audiological Testing
References
Part IV: Rhinology and Allergy During Pregnancy and the Postpartum Period
41: Rhinosinusitis During Pregnancy and the Postpartum Period
41.1 Introduction
41.2 Respiratory System Physiology in Pregnancy
41.3 Rhinitis Symptoms and Signs
41.3.1 Nasal Congestion and Difficulty Breathing through the Nose
41.3.2 Itching in the Nose
41.3.3 A Discharge from the Anterior or Posterior of the Nose
41.3.4 Odor Disorder
41.4 Clinical Approach
41.5 Pregnancy Rhinitis
41.6 Treatment
41.6.1 Common Cold
41.6.2 Rhinosinusitis
41.6.3 Acute Rhinosinusitis (ARS)
41.6.4 Acute Viral RS
41.6.5 Acute Bacterial RS
41.6.6 Chronic Rhinosinusitis
41.7 Symptoms
41.8 Physical Examination Findings
41.9 Complications
41.10 Radiological Imaging
41.11 Microbiological Tests
41.12 Treatment
41.12.1 Nonpharmacological Treatments
41.12.2 Pharmacological Treatments
41.12.3 Surgical Treatment
41.12.4 Postpartum Infection Control
41.12.5 Breastfeeding
References
42: The Management of Nasal Obstruction During Pregnancy and the Postpartum Period
42.1 Introduction
42.2 Dynamic Causes
42.3 Structural Causes
42.3.1 Septal Deviation
42.3.2 Turbinate Hypertrophy
42.4 Rhinitis
42.4.1 Allergic Rhinitis
42.4.2 Hormonal Rhinitis/Pregnancy-Induced Rhinopathy
42.4.3 Acute Infectious Rhinitis
42.5 Rhinosinusitis
42.5.1 Chronic Rhinosinusitis with Nasal Polyps
42.6 Neoplasias
42.6.1 Nasal Granuloma Gravidarum
42.7 Conclusion
References
43: Smell and Taste Disorders During Pregnancy and the Postpartum Period
43.1 Introduction
43.2 Sense of Smell
43.2.1 Anatomy and Physiology
43.2.2 Evaluation of the Sense of Smell
43.2.2.1 Psychophysical Tests
43.2.2.2 Electrophysiological Tests
43.2.3 Smell Disorders
43.2.4 Etiology of Smell Disorders
43.3 Sense of Smell During Pregnancy and the Postpartum Period
43.3.1 Olfactory Thresholds During Pregnancy and the Postpartum Period
43.3.2 Identification Thresholds During Pregnancy and the Postpartum Period
43.3.3 Odor Intensity Ratings During Pregnancy and the Postpartum Period
43.3.4 Hedonics, Disgust, and Nausea-Vomiting During Pregnancy
43.3.5 Possible Underlying Causes of Changes in the Sense of Smell During Pregnancy
43.4 Sense of Taste
43.4.1 Anatomy and Physiology
43.4.2 Evaluation of the Sense of Taste
43.4.3 Taste Disorders
43.4.4 Etiology of Taste Disorders
43.5 Sense of Taste During Pregnancy and the Postpartum Period
43.5.1 Taste Thresholds During Pregnancy and the Postpartum Period
43.5.2 Changes in Perceived Taste Intensity During Pregnancy and the Postpartum Period
43.5.3 Changes in the Sense of Taste during Pregnancy and the Postpartum Period
43.6 Treatment
References
44: Management of Epistaxis During Pregnancy and the Postpartum Period
44.1 Introduction
References
45: Allergic Rhinitis During Pregnancy
45.1 Introduction
45.2 Signs and Symptoms
45.3 Diagnosis
45.3.1 History
45.3.2 Examination
45.3.3 Tests for Specific IgE
45.4 Treatment
45.4.1 Cromolyn Sodium Nasal Spray
45.4.2 Glucocorticoid Nasal Sprays
45.4.3 Oral Antihistamines
45.4.4 Antihistamine Nasal Sprays
45.4.5 Decongestants
45.4.6 Montelukast
45.4.7 Allergen Immunotherapy
45.5 Conclusions
References
46: Gestational Rhinitis
46.1 Introduction
46.2 Gestational Rhinitis
46.2.1 GR History
46.2.2 Incidence and Prevalence
46.2.3 Etiology and Physiopathology
46.3 Pregnancy Hormones and Nasal Physiology
46.3.1 Estrogen
46.3.2 Progesterone
46.3.3 Prolactin
46.3.4 Neuropeptides
46.3.5 Placental Growth Hormone
46.4 Risk Factors
46.5 Diagnosis and Clinical Significance
46.6 Impact on Quality of Life
46.7 Differential Diagnosis
46.8 Treatment
46.8.1 Conservative Treatment
46.8.1.1 Physical Exercise
46.8.1.2 Nasal Saline Irrigation
46.8.2 Pharmacological Treatment
46.8.2.1 Decongestant
46.8.2.2 Glucocorticoids
46.8.2.3 Antibiotics
46.8.2.4 Antihistamine
46.8.3 Other Treatments
46.8.3.1 Nasal Continuous Positive Airway Pressure (CPAP)
46.8.3.2 Surgery
46.8.3.3 Nonallergic Rhinitis in Pregnancy
References
47: Nasal Polyposis During Pregnancy and the Postpartum Period
47.1 Introduction
47.2 Medical Treatment
47.2.1 Nasal Saline Irrigation
47.2.2 Antibiotics
47.2.3 Intranasal Antibiotics
47.3 Histamine Receptor Antagonists
47.4 Intranasal Antihistamines
47.5 Corticosteroids
47.5.1 Intranasal Corticosteroids
47.6 Antileukotrien Drugs
47.7 Surgical Treatment
References
48: Pregnancy Rhinorrhoea
48.1 Introduction
48.2 Causes
48.3 History
48.4 Differential Diagnosis in a Case of Rhinorrhoea
48.4.1 Cerebrospinal Fluid (CSF) Rhinorrhoea
48.4.1.1 CSF Rhinorrhoea Due to Trauma
48.4.1.2 Iatrogenic CSF Rhinorrhoea
48.4.1.3 CSF Rhinorrhoea Related to a Tumour
48.4.1.4 Congenital CSF Rhinorrhoea
48.4.1.5 Spontaneous CSF Rhinorrhoea
48.5 Treatment Options
References
Part V: Laryngology
49: Laryngopharyngeal Reflux During Pregnancy and Lactation
49.1 Introduction
49.2 Epidemiology
49.3 Pathophysiology
49.4 Clinical Presentation
49.5 Diagnosis
49.6 Treatment
49.6.1 Dietary and Lifestyle Modification
49.6.2 Pharmacotherapy
49.7 Treatment in Breastfeeding Women
49.8 Laryngitis During Pregnancy and Lactation
49.8.1 Acute Laryngitis
49.8.2 Therapy in Pregnant Patients
49.8.3 Advice for Preventing Laryngitis During Pregnancy and Lactation
49.9 Acute Epiglottitis (Supraglottitis)
49.9.1 Treatment During Lactation
References
50: Voice Disorders and Therapy During Pregnancy and the Postpartum Period
50.1 Introduction
50.2 Etiological Factors
50.2.1 Hormonal Changes
50.2.2 Anatomic and Physiological Changes
50.2.3 Metabolic Changes
50.2.4 Psychological Changes
50.3 Treatment Methods
References
51: Benign and Premalignant Lesions of the Larynx During Pregnancy and the Postpartum Period
51.1 Introduction
51.2 Benign Lesions of the Larynx During Pregnancy and Postpartum Period
51.2.1 Laryngeal Papillomatosis
51.2.2 Vocal Fold Polyps
51.2.3 Reinkes’s Edema
51.2.4 Vocal Fold Cysts
51.2.5 Vocal Fold Nodules
51.2.6 Vocal Process Granulomas
51.2.7 Postintubation Granuloma of the Larynx
51.3 Premalignant Lesions of the Larynx During Pregnancy and Postpartum Period
51.4 Management
References
Part VI: Head and Neck Neoplasms and Surgery During Pregnancy and the Postpartum Period
52: Head and Neck Cancer in Pregnancy
52.1 Introduction
52.1.1 Signaling Pathway Changes
52.1.2 Immune Evasion
52.1.3 Hormone Induction
52.1.4 Virus Induction
52.2 Subsites Involved in Head and Neck Cancer in Pregnancy
52.2.1 Nasal and Paranasal Cancer
52.2.2 Nasopharyngeal Cancer
52.2.3 Oral Cavity Cancer
52.2.4 Oropharyngeal Cancer
52.2.5 Laryngeal and Hypopharyngeal Cancers
52.2.6 Salivary Gland Cancers
52.2.7 Nonmelanoma Skin Cancers (NMSCs) and Melanoma
52.2.8 Lymphoma
52.2.9 Leukemia
52.3 Management Principles
52.3.1 Goals/Dilemmas
52.3.2 Radiographic Studies
52.3.3 Treatment Timing
52.3.4 Chemotherapy
52.3.5 Radiation Therapy
52.3.6 Surgery
52.3.7 Elective Termination of Pregnancy
52.4 Conclusion
References
53: The Management of Neck Mass During Pregnancy and the Postpartum Period
53.1 Introduction
53.2 Differential Diagnosis
53.3 Diagnostic Tools
53.3.1 History
53.3.2 Physical Examination
53.3.3 Diagnostic Imaging
53.3.3.1 Ultrasound Imaging
53.3.3.2 Computed Tomography and Magnetic Resonance Imaging
53.3.4 Ancillary Testing
53.3.5 Biopsy
53.3.5.1 Fine-Needle Aspiration Biopsy
53.3.5.2 Core Biopsy
53.3.5.3 Open Biopsy
53.3.6 Panendoscopy
53.4 Diagnostic Workup
53.5 Management of Benign Neck Masses
53.5.1 Medical Treatment
53.5.2 Surgical Treatment
References
54: Cough During Pregnancy and Lactation
54.1 Introduction
54.2 Anatomical and Physiological Changes in the Respiratory System During Pregnancy
54.3 Cough
54.3.1 Etiology
54.3.2 Clinical Evaluation
54.4 Upper Airway Cough Syndrome
54.5 Pregnancy Rhinitis
54.6 Pregnancy and Allergic Rhinitis
54.7 Pregnancy and Vasomotor Rhinitis
54.8 Pregnancy and Gastroesophageal Reflux
54.9 Asthma in Pregnancy
54.10 Treatment
54.10.1 Nasal Saline Irrigation
54.10.2 Intranasal and Oral Decongestants
54.10.3 Corticosteroids
54.10.4 Antihistamines
54.10.5 Leukotriene Receptor Antagonists
54.10.6 Antitussives
54.10.7 Immunotherapy
References
55: Salivary Gland Infectious and Inflammatory Diseases During Pregnancy and the Postpartum Period
55.1 Introduction
55.2 Parotid Gland
55.3 Submandibular Gland
55.4 Sublingual Gland
55.5 Physiology
55.6 Patient History and Physical Examination
55.7 Ultrasonography (USG)
55.8 Computed Tomography (CT)
55.9 Magnetic Resonance Imaging (MRI)
55.10 Endemic Parotitis: Viral Parotitis
55.11 Acute Suppurative Sialadenitis
55.12 Sialolithiasis
55.13 Chronic Recurrent Sialadenitis
55.14 Sialadenosis
55.15 Granulomatous Sialadenitis
55.16 Sjogren’s Syndrome
55.17 Points to Consider in Treatment
References
56: Thyroid Nodules and Cancer During Pregnancy and the Postpartum Period
56.1 Introduction
56.2 Physiological Changes in the Thyroid Gland in Pregnant Women
56.3 Diagnosis
56.4 Thyroid Nodules and Thyroid Cancer
56.4.1 Thyroid Nodules
56.4.1.1 Epidemiology
56.4.1.2 Diagnosis
56.4.1.3 Management of Thyroid Nodules in Pregnant Patients
56.4.2 Thyroid Carcinoma
56.4.2.1 Differentiated Thyroid Carcinoma (DTC)
Progression, Risk of Recurrence, and Prognosis
Management
Evaluation and Management of Thyroid Cancer During Pregnancy
56.5 Active Surveillance (Watchful Waiting)
56.6 Surgery
56.7 Radioactive Iodine
56.8 Thyroid Hormone Management
56.9 Tyrosine Kinase Inhibitors (TKIs)
56.10 Considerations for the Postpartum Period
56.11 Preconception Planning and Counselling
56.12 Management of Pre-existing Thyroid Cancer During Pregnancy
References
57: Management of Parathyroid Disorders in Pregnancy and Postpartum Period
57.1 Introduction
57.2 Calcium and Other Minerals, Vitamin D, Parathyroid Hormone (PTH), Calcitonin Physiology in Pregnancy and Lactation
57.2.1 Calcium and Other Minerals
57.2.2 PTH
57.2.3 Vitamin D Metabolism
57.2.4 Calcitonin
57.2.5 Parathyroid Hormone–Related Protein (PTH-rP)
57.3 Calcium Absorption and Metabolism in Pregnancy and Lactation
57.3.1 Intestinal Calcium and Phosphate Absorption
57.3.2 Renal Handling
57.3.3 Skeletal Calcium Metabolism
57.4 Calcium Disorders During Pregnancy and Lactation
57.4.1 Osteoporosis
57.4.2 Hypoparathyroidism
57.4.3 Hyperparathyroidism
57.4.4 Vitamin D Insufficiency and Deficiency
57.5 Conclusion
References
Part VII: Lower Airway Diseases During Pregnancy and the Postpartum Period
58: Pulmonary Physiologic Adaptations During Pregnancy
58.1 Introduction
58.2 Anatomic Changes
58.2.1 Upper Airways
58.2.2 Chest Anatomy
58.3 Functional Changes
58.3.1 Lung Volumes
58.3.2 Oxygen Consumption: Carbon Dioxide Production
58.3.3 Ventilation
58.3.4 Blood Gases
58.3.5 Plasma and Blood Volume Increase
58.3.6 Blood Cell Increase
58.3.7 Diffusion Capacity for Carbon Monoxide (DLCO)
58.3.8 Lung Functions
58.4 Changes Caused by Exercise in Pregnant Women
58.5 Changes in Pregnant Women Living at High Altitude
58.6 Sleep-Disordered Breathing During Pregnancy
58.7 Dyspnea
58.8 Adaptations Related to Birth
References
59: Lower Respiratory Infections During Pregnancy
59.1 Introduction
59.2 Acute Bronchitis
59.3 Community-Acquired Pneumonia (CAP)
59.4 Influenza Pneumonia
59.5 COVID-19
References
60: Bronchitis During Pregnancy and in the Postpartum Period
60.1 Introduction
60.2 Symptoms and Clinical Findings
60.3 Microbiological Factors
60.4 Maternal Consequences
60.5 Consequences for the Fetus or Neonate
60.6 Treatment and Prophylaxis
60.7 Antibacterial Therapy
60.8 Antiviral Therapy
60.9 Prophylactic Vaccination
References
61: Bacterial Pneumonia During Pregnancy
61.1 Introduction
61.2 Community-Acquired Pneumonia in Pregnancy
61.2.1 Clinical Properties and Physical Examination
61.2.2 Laboratory Findings and Imaging
61.2.3 Treatment and Follow-Up
61.2.4 Complications
61.2.5 Prevention
61.3 Hospital-Acquired Pneumonia in Pregnancy
61.3.1 Etiopathogenesis
61.3.2 Diagnosis
61.3.3 Treatment
61.4 Conclusion
References
62: Pregnancy and Postpartum Period Community-Acquired Pneumonia
62.1 Introduction
62.2 Pneumonia During Pregnancy
62.2.1 Pathophysiology and Risk Factors
62.2.2 Diagnosis
62.2.3 Etiology
62.2.4 Clinical Course
62.2.5 Bacterial Pneumonia
62.2.6 Viral Pneumonia
62.2.6.1 Influenza Virus
62.2.6.2 Varicella
62.2.6.3 Coronavirus Infections
62.2.7 Fungal Pneumonia
62.2.8 Pneumonia in HIV Patients
62.3 Future Directions for CAP in Pregnancies
62.4 Postpartum Pneumonia
References
63: Tuberculosis During Pregnancy
63.1 Introduction
63.2 Effects of Pregnancy on Tuberculosis
63.3 Effects of Tuberculosis on Pregnancy
63.4 Tuberculosis and Newborn
63.5 Latent Tuberculosis Infection and Treatment in Pregnancy
63.6 Clinical Findings and Diagnosis of Active Tuberculosis in Pregnancy
63.7 Active Tuberculosis Treatment in Pregnancy
63.8 Multidrug-Resistant Tuberculosis (MDR-TB) in Pregnancy
63.9 Conclusion
References
64: Pulmonary Embolism During Pregnancy and the Postpartum Period
64.1 Introduction
64.2 Diagnosis of PE
64.2.1 Laboratory Tests
64.2.1.1 D-Dimer
64.2.1.2 Arterial Blood Gas Analysis
64.2.2 Compression Ultrasound (CUS)
64.2.3 Echocardiography
64.2.4 Imaging
64.2.4.1 Chest X-Ray
64.2.4.2 MR Pulmonary Angiography (MRPA)
64.2.4.3 Computed Tomography Pulmonary Angiography (CTPA) and Perfusion Scan
64.3 Treatment
64.4 Amniotic Fluid Embolism
References
65: Asthma During Pregnancy and Lactation
65.1 Introduction
65.2 Respiratory Physiology During Pregnancy
65.3 Effects of Pregnancy on Asthma
65.4 Maintaining Asthma Control
65.4.1 Pharmacological Therapy
65.4.2 Non-pharmacologic Treatments
65.4.2.1 Patient Education
65.4.2.2 Smoking Cessation
65.4.2.3 Control of Environmental Triggers
65.4.3 Acute Exacerbations
65.5 Maternal and Fetal Monitoring
65.5.1 Maternal Monitoring
65.5.2 Fetal Monitoring
65.6 Supportive Care
65.6.1 Maternal Positioning
65.6.2 Hydration
65.6.3 Medications
65.6.4 Respiratory Infections
65.6.5 Peripartum Care
65.7 Lactation and Asthma
65.7.1 Drug Use in Lactation
References
66: Restrictive Lung Diseases in Pregnancy
66.1 Introduction
66.2 Diffuse Parenchymal Lung Diseases
66.2.1 Drug-Induced Lung Diseases in Pregnancy
66.2.2 Connective Tissue Disease-Related Interstitial Lung Disease in Pregnancy
66.2.3 Idiopathic Interstitial Pneumonitis in Pregnancy
66.2.4 Granulomatous Diffuse Parenchymal Lung Diseases in Pregnancy
66.2.5 Other Forms of Diffuse Parenchymal Lung Diseases in Pregnancy
66.3 Diseases of the Chest Wall in Pregnancy
66.4 Neuromuscular Disorders in Pregnancy
References
Part VIII: Miscellaneous Topics
67: Complementary Medicine Products for Use in Pregnancy and the Postpartum Period
67.1 Introduction
67.2 Complementary and Herbal Medicine
67.2.1 Traditional Chinese Medicine
67.2.2 Omega-3 Dietary Supplements
67.2.3 Quality and Efficacy
67.2.3.1 Quality
67.2.3.2 Efficacy
67.3 Complementary Medicine in Pregnancy and Lactation
67.3.1 Pregnancy and Nursing
67.3.2 Infants and Children
References
68: Afflictions of Postpartum Mental Health
68.1 Introduction
68.2 Postpartum Blues
68.2.1 Clinical Characteristics
68.2.2 Epidemiology
68.2.3 Assessment
68.2.4 Risk Factors
68.2.5 Etiology
68.2.6 Prognosis
68.2.7 Differential Diagnosis
68.3 Postpartum Depression
68.3.1 Clinical Characteristics
68.3.2 Epidemiology
68.3.3 Assessment
68.3.4 Risk Factors
68.3.5 Differential Diagnosis
68.3.6 Treatment and Prevention
68.4 Postpartum Anxiety and OCD (Obsessive Compulsive Disorder)
68.4.1 Clinical Characteristics
68.4.2 Epidemiology
68.4.3 Assessment
68.4.4 Risk Factors
68.4.5 Prognosis
68.4.6 Differential Diagnosis
68.4.7 Treatment and Prevention
68.5 Postpartum Psychosis
68.5.1 Clinical Characteristics
68.5.2 Epidemiology
68.5.3 Risk Factors
68.5.4 Prognosis
68.5.5 Differential Diagnosis
68.5.6 Treatment and Prevention
References
69: Filler and Neurotoxin Injections During Pregnancy and the Postpartum Period
69.1 Introduction
69.1.1 Fillers
69.2 Fillers in Pregnancy
69.3 Neurotoxins
69.4 Neurotoxin Injections in Pregnant Women
69.4.1 Experimental Reports
69.4.2 Human Reports
69.5 Neurotoxins During Postpartum Period
References
70: Female Voice During Pregnancy and Postpartum Period
70.1 Introduction
70.2 Voice in Menstrual Period
70.3 Voice in Pregnancy
70.4 Voice in Postpartum Period
70.5 Voice in Postmenopausal Period
70.6 Conclusion
References
71: Nutritional Approaches to Decrease Allergy Outcomes in the Offspring of Allergic Mothers
71.1 Introduction
71.2 Energy Requirement
71.3 Macronutrients
71.3.1 Protein
71.3.2 Carbohydrates
71.3.3 Fiber
71.3.4 Lipids
71.4 Micronutrients
71.4.1 Vitamins and Minerals
71.5 How to Prevent or Decrease Atopic Outcomes of the Offspring During Pregnancy and Lactation
71.6 Nutritional Approach in Lactation and Pregnancy to Reduce Allergic Outcomes
71.7 The Mediterranean Diet
References
72: Management of Vascular Lesions During Pregnancy and Postpartum Period
72.1 Introduction
72.2 Vascular Tumors
72.2.1 Infantile Hemangioma
72.2.2 Congenital Hemangioma
72.2.3 Tufted Angioma
72.2.4 Spindle Cell Hemangioma
72.2.5 Epithelioid Hemangioma
72.2.6 Pyogenic Granuloma
72.2.7 Kaposiform Hemangioendothelioma
72.2.8 Kaposi Sarcoma
72.2.9 Angiosarcoma
72.2.10 Epithelioid Hemangioendothelioma
72.2.11 Angiofibroma
72.2.12 Paraganglioma
72.2.13 Tympanic Paraganglioma
72.2.14 Jugular Paraganglioma
72.2.15 Vagal Paraganglioma
72.2.16 Hemangiopericytoma
72.2.17 Vascular Malformations
72.2.18 Capillary Malformation
72.2.19 Venous Malformation
72.2.20 Lymphatic Malformation
72.2.21 Arteriovenous Malformation
References
73: General Principles of Ent Surgery in Pregnancy
73.1 Introduction
73.2 Rhinology
73.2.1 Epistaxis
73.2.1.1 Granuloma Gravidarum
73.2.1.2 Complications of Sinusitis
73.3 Otology–Neurotology
73.4 Larynx
73.4.1 Hemangioma
73.4.2 Idiopathic Subglottic Stenosis
73.4.3 Cord Vocal Paralysis
73.5 Approach to Head Neck Tumors
73.5.1 Oral Cavity Cancers
73.5.2 Nasal Cavity Cancers
73.5.3 Larynx Cancers
73.6 Thyroid and Parathyroid Surgery
73.6.1 Thyroid Surgery
73.6.2 Parathyroid Surgery
References