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Pregnancy

Otolaryngology and the Pregnant Patient

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1 Credit CME

JAMA Otolaryngology–Head & Neck Surgery

Published Online: August 24, 2023

Review

Article Information and Disclosures

Claire M. Lawlor, MD¹;

M. Elise Graham, MD²;

Lynsey C. Owen, MD³;

Lauren F. Tracy, MD⁴

Author Affiliations

¹Department of Otolaryngology, Children’s National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC
²Department of Otolaryngology–Head and Neck Surgery, London Health Sciences Centre and Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
³Department of Obstetrics and Gynecology, Virginia Hospital Center, Arlington, Virginia
⁴Department of Otolaryngology–Head and Neck Surgery, Boston Medical Center, Chobanian and Avedisian School of Medicine at Boston University, Boston, Massachusetts

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Abstract

Importance Pregnancy may result in physiologic and pathologic changes in the head and neck. Otolaryngologists may need to intervene medically or surgically with pregnant patients. Careful consideration of risks to both the gravid patient and the developing fetus is vital.

Observations Patients may present with otolaryngologic complaints exacerbated by or simply occurring during their pregnancy. Symptoms of hearing loss, vertigo, rhinitis or rhinosinusitis, epistaxis, obstructive sleep apnea, sialorrhea, voice changes, reflux, subglottic stenosis, and benign and malignant tumors of the head and neck may prompt evaluation. While conservative measures are often best, there are medications that are safe for use during pregnancy. When required, surgery for the gravid patient requires a multidisciplinary approach.

Conclusions and Relevance Otolaryngologic manifestations in pregnant patients may be managed safely with conservative treatment, medication, and surgery when necessary. Treatment should include consideration of both the pregnant patient and the developing fetus.

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Article Information

Accepted for Publication: July 3, 2023.

Published Online: August 24, 2023. doi:10.1001/jamaoto.2023.2558

Corresponding Author: Claire M. Lawlor, MD, Department of Otolaryngology, Children’s National Medical Center, 111 Michigan Ave NW, Washington, DC 20010 (clairemlawlor@gmail.com).

Author Contributions: Dr Lawlor had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Lawlor, Graham, Tracy.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Lawlor, Tracy.

Critical review of the manuscript for important intellectual content: All authors.

Supervision: Lawlor, Tracy.

Conflict of Interest Disclosures: None reported.

Disclaimer: Dr Lawlor is the Patient Page Editor of JAMA Otolaryngology—Head & Neck Surgery, but she was not involved in any of the decisions regarding review of the manuscript or its acceptance.

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 credit toward the CME [and Self-Assessment requirements] of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.