Can pregnancy be treated with hormones, the mother-to-be cried and said she didn't want to be born prematurely...

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He was transferred to 3 departments for the treatment of deafness

It's not easy to be a mom. On this day, a tearful mother-to-be came to the clinic.

It turned out that the 35-year-old pregnant mother was pregnant for the first time, and now the baby has 37 weeks and 6 days. She suddenly had a sustained tinnitus in her left ear three days ago, and her was examined by an otolaryngologist, and there were no abnormalities in the external auditory canal and eardrum, but the low-frequency was impaired (low-frequency sounds were not audible). The doctor recommends initiating hormone therapy and referring her to the obstetrics and gynecology department to assess whether she can give birth early and then undergo hormone therapy after giving birth.

The mother-to-be felt sorry for the baby, couldn't help but shed tears, and didn't want to give birth early, so the obstetrics and gynecology department referred to the pharmacy clinic to assess the risk of hormone therapy for the baby and the pregnant mother.

1

Sudden deafness during pregnancy

Sudden deafness is a sudden and rapid appearance of hearing damage, can be manifested as hearing loss, some friends manifest as ear blockage, ear stuffiness, common unilateral ear problems, and unilateral sudden deafness 90% will appear tinnitus, the mother-to-be, is to unilateral tinnitus as the main symptom.

2

Will hearing be restored?

Whether or not hearing can be restored depends on the severity of hearing damage and the cause. Early diagnosis and treatment can help improve prognosis.

Therefore, once there is discomfort in the ear, it is necessary to evaluate the hearing situation as soon as possible.

3

Treatment of sudden deafness

The treatment of sudden deafness is with glucocorticoids. It is best to start within 2 weeks of the onset of symptoms and no later than 6 to 8 weeks after the onset of symptoms. Choose oral prednisone, 60 mg, once a day for 10 days. Hearing is reviewed two weeks after treatment to assess efficacy.

Friends have heard that the side effects of hormones are large, if pregnant women use hormones, then will it cause unimaginable harm to pregnant mothers and fetuses?

Not really. The mother-to-be is in the third trimester, and it is safer for the baby to use prednisone at this time. Because prednisone enters the placenta, most of it is metabolized by placenta enzymes, and the amount of entering the fetus is very low.

So, does it have an impact on pregnant mothers? Even using it for 10 days doesn't have much effect. In general, even for 21 days of <, the hormone does not affect the HPA axis (hypothalamic-pituitary-adrenal cortex axis) of pregnant mothers.

I comforted the sad mother-to-be. Tell her that, first of all, in the middle and third trimesters, the use of hormones does not lead to fetal malformations. You're in your third trimester, don't worry.

Secondly, the use of prednisone in the middle and third trimesters, as long as the daily dose does not exceed 80 mg, is not a long-term use, will not affect the growth and development of the baby. Finally, prednisone is used continuously for 10 days, the time is short, the impact on you is relatively small, there may be gastrointestinal side effects, mental excitement, increased appetite, these side effects are not serious, after stopping the drug will completely disappear.

After listening to my analysis, the mother-to-be's mood also calmed down. After consulting with her family, she called me and decided to minimize the risk to the baby. It was time to give birth early, so it was decided to induce labor in hospital, give birth early, and undergo hormone therapy after giving birth. I wish her a smooth birth and a lovely baby.

4

Effects of hormones on pregnant mothers and fetuses

It depends on which stage of pregnancy you are at, which hormone is chosen, the dose, and how long you use it.

For example, in the first trimester, in the first trimester, because the function of the placenta has not yet been fully formed, prednisone can not be metabolized by placental enzymes, at this time, if the daily dose of prednisone is greater than 15 grams, there is a risk of cleft lip and palate, and should be avoided as much as possible. In the middle and third trimesters, short-term use of prednisone in non-oversized doses is safe for both pregnant mothers and fetuses.

However, long-term use of large doses may pose risks to pregnant mothers, such as premature rupture of membranes, hyperglycemia and infection. There is also a risk to the fetus, resulting in intrauterine growth restriction, manifested as low-weight infants. In addition, dexamethasone is not very much metabolized by placenta enzymes, and the dose into the fetus is more, so for pregnant mothers who need to give birth in advance, dexamethasone is often used to promote fetal lung maturation.

Finally, the prognosis of sudden deafness is emphasized. The overall prognosis for sudden deafness is generally good, with about two-thirds of patients regaining some level of hearing. Recovery is usually achieved within three months. The less severe the hearing impairment, the more likely it is to recover hearing. Simple high-frequency or low-frequency hearing impairment has a good prognosis.

Compared with high-frequency hearing impairment, low-frequency hearing impairment has a good prognosis, and the presence of tinnitus without vertigo is good. So this mother-to-be should be able to fully recover.

Source of this article: Ji Lianmei pharmacist

Author of this article: Ask the pharmacist Zheng Ping

Editor-in-Charge: Ichikawa