Purulent otitis media during pregnancy treatment

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Vereshchak Vladimir Vasilievich

Otolaryngologist (ENT) of the first category

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Otitis is a disease of the middle, outer or inner ear. The occurrence of complications usually occurs after viral and acute viral infections, diseases of the nasopharynx, and wetting of the ear. It is characterized by throbbing pain, a shooting sensation in the ear, general weakness, fever, and accumulation of pus in the ear sinuses.

Otitis media during pregnancy is a fairly common occurrence; it is during this period that the female body is especially susceptible to the effects and perception of various bacteria, and provocation from diseases.

Symptoms of otitis media during pregnancy

Hormonal fluctuations and reduced immunity are natural characteristics of the female body during pregnancy and childbirth. Under the influence of such factors, colds often occur in expectant mothers. The transition from ARVI to other inflammatory processes occurs quite quickly.

Otitis media during pregnancy is a serious problem. Treatment should be prescribed and monitored by a doctor. Without timely and qualified help, otitis media in a pregnant woman can lead to temporary hearing loss, meningitis and a number of other problems. The first characteristic signs of otitis media are a signal that you need to seek medical help.

Usually, otitis media in a pregnant woman begins to manifest itself in the form of a slight malaise: weakness, slight dizziness, nasal congestion, hearing loss. The temperature is slightly elevated or remains normal. Even with such symptoms, you should definitely consult a doctor to find out how to treat otitis media at different stages of pregnancy. Complications must not be allowed to develop, such as the appearance of extraneous sounds and pain in the ear, headaches, and especially to the point of accumulation of pus in the ear canals. All this indicates that otitis media is progressing, and in pregnant women such processes can cause disturbances in the development of the fetus.

Acute otitis media is considered very dangerous. The disease is characterized by severe pain, sinus congestion, sometimes with purulent discharge and fever.

Acute purulent otitis media is treated using antibacterial drugs. They are prescribed by the doctor, taking into account the current condition of the patient and the stage of pregnancy. When the purulent mass collected in the ear canal does not respond to medication and does not leave the ear, and the eardrum ruptures. The doctor punctures the purulent formation, and the patient’s condition improves, with gradual restoration of hearing.

When prescribing treatment for otitis during pregnancy, the doctor takes into account the current state of the disease and the duration. How and how to treat otitis media during pregnancy, in the form of acceptable medications and other treatment methods, is prescribed by the doctor. Not all medications can be taken during pregnancy. Drug intervention in the first trimester is considered especially dangerous.


Signs of otitis media during pregnancy may vary. This depends on the state of immunity and the presence of chronic inflammatory diseases of the ENT organs. Often, otitis media is of moderate severity and is manifested by pain and intoxication syndromes. Less commonly, inflammation remains unnoticeable for a long time. The asymptomatic course is associated with a decrease in the body's defenses; it is more often observed with chronic otitis media.

Catarrhal otitis media

The following clinical manifestations of pathology are distinguished:

  • Ear pain.
  • Increase in body temperature to 37-38 degrees.
  • Headache.
  • General weakness.
  • Discharge of serous fluid or pus from the ear canal.
  • Feeling of fullness in the ears.
  • Hearing impairment.

Symptoms depend on the form of the disease. With external otitis, there is itching of the skin in the ear area and redness. Inflammation of the hair follicle – boil – may develop. In this case, there is a sharp pain when touching the auricle, and hearing loss. The temperature is usually low-grade. Unpleasant symptoms begin to fade when the boil breaks through. Inflammation of the middle ear is more severe. Painful sensations arise due to distension of the tympanic cavity by accumulated exudate. In this case, the woman experiences severe pain inside the ear. Due to the swelling, there is a feeling of congestion and hearing loss. In some cases, there is ringing in the ears and fluid transfusion.

The main symptom of otitis media is ear pain

Symptoms of internal otitis differ from signs of damage to the external and middle sections. The labyrinth is an anatomical formation that is responsible not only for hearing, but also for coordination of movements. Therefore, when it is inflamed, nausea, vomiting and dizziness are observed. When the inflammatory focus breaks through, suppuration is observed. This symptom is considered a favorable sign, as it indicates a speedy recovery.

Acceptable methods of treating otitis media during pregnancy

During pregnancy, treatment of otitis should be strictly under the supervision of a doctor. Existing contraindications for the use of medications during pregnancy cause difficulties in the question of how to treat otitis media during pregnancy. Since the list of prescribed medications to solve the problem is becoming much smaller.

In general, complex treatment of otitis in pregnant women includes the following methods:

  • Rinsing, instillation, compresses, warming up the ear canals.
  • Physiotherapeutic procedures.
  • Antihistamines, antipyretics and anti-inflammatory drugs.
  • Antibiotics.
  • Surgical intervention.

In early pregnancy, when treating otitis media, under the influence of medications, there is a risk of various pathologies and fetal death. During this period, he is especially susceptible to any infections, because the formation of organs and systems occurs. Treatment should be based on non-aggressive drugs with a phytotherapeutic basis. Weeks 13-28 are considered the calmest for influencing the inflammatory process. In the third trimester, the placenta protects the fetus from mild forms of medications other than antibiotics.

With intensive treatment and prolongation of the disease, pathogenic microflora can harm the child: placental abruption, fetal hypoxia, even premature birth.

Ear drops are prescribed only to relieve general inflammation. If the eardrum is ruptured, only nasal drops are acceptable. You should also be careful with them because of their vasoconstrictive effect, which can harm the fetus. They cannot be used independently; such drugs should only be prescribed by a doctor, after an objective assessment of all contraindications. Since otitis media during pregnancy is accompanied by fluid filling of the nasal sinuses, an adequate procedure instead of drops would be rinsing with a solution of soda and salt.

If the expectant mother, before conceiving a child, experienced periodic inflammation of the ears, turning into a chronic form and with relapses several times a year. In this case, preventive measures should be taken to prevent the onset of symptoms and exacerbation. When hearing begins to decline, surgery may be necessary. This will not affect the development of the fetus, but it is advisable to carry it out in the second trimester.

Severe ear pain may indicate an accumulation of pus inside the ear canal. You cannot make a decision on warming up your ear on your own. Since the thermal effect can increase the likelihood of infection spreading throughout the body, for example, to the brain.

When treating otitis media in a pregnant woman, you should:

  • clean your ears very carefully;
  • in case of purulent accumulations, do not heat the ear;
  • only if there is an urgent need to use medications that reduce fever and eliminate severe pain;
  • exclude from the diet foods that cause allergies and obvious carcinogens.

During treatment, folk remedies can accompany medication.

Drug therapy for otitis media in pregnant women

In addition to the non-drug therapy described above, some medications may also be used. The range of drugs for the treatment of otitis in pregnant women is quite small, so as not to harm the child.

That is why, to begin with, medications based on medicinal and natural oils are prescribed. And even this appointment is made with great care.

If we talk about antibiotics, they are prescribed extremely rarely and mainly only for acute forms of otitis. Drugs that may be prescribed include:

  1. Biseptol.
  2. Amoxicillin.

Antibacterial therapy for pregnant women is prescribed only in extreme cases

If the patient follows all the doctor’s instructions, treatment of the disease will take about a week . And it will take another week to eliminate residual signs of the disease.

It is unacceptable to select medications on your own . This is especially true for ear drops. Among the huge variety of such, only a few can be used during pregnancy.

Traditional treatment

The main treatment of otitis in pregnant women can be accompanied by the use of proven folk remedies: rinsing and drops in the ear canal, heating, compresses. Folk remedies for otitis media with a reasonable approach to use speed up the healing process.

  1. Rinsing the outer part of the ear with chamomile infusion. One teaspoon of flowers per glass of boiling water, pour in, leave for two hours. The frequency of ear rinsing is at least 4 times a day. The product is antiseptic and anti-inflammatory.
  2. A cotton swab soaked in Kalanchoe and aloe juice, proportions 1:1. Place in the ear canal for 1-2 hours. Reduces discomfort and pain. Onion juice has the same effect.
  3. Warm decoction of bay leaves for rinsing the ear. The frequency of manipulation is 1 time per day. Contraindication: eardrum injury.
  4. Propolis ear drops. Combine propolis tincture with vegetable oil (1:4). Instill 1-2 drops a couple of times a day.
  5. Place a clean and crushed geranium leaf in the sore ear for 1-2 hours

Natural herbs and oils help eliminate otitis media during pregnancy. These are the safest ways to treat inflammation in pregnant women, especially during the 1st trimester.

All folk remedies that contain alcohol should be treated with caution. Since it can penetrate the placenta to the fetus and lead to developmental disorders.

Treatment with folk remedies requires consultation with your doctor and listening to your own feelings.


Three types of disease are differentiated based on the location of the source of inflammation.

Otitis externa

The external form – inflammation of the external parts of the ear canal, is characterized by a feeling of itching and noise.

The reasons for the development of this form of the disease are banal: frequent and intensive procedures to cleanse earwax.

A woman may experience short-term hearing problems. Moderate pain may be accompanied by a slight increase in temperature and scanty discharge.

Otitis media

Symptoms of this type of disease develop as a complication after acute bacterial or viral infections of the nasopharynx, upper respiratory tract, and external otitis media. The inflammatory process involves the skin of the outer ear, the tissue of the mastoid process, and the parotid salivary gland.

Pathogens: staphylococcus, pneumococcus, Haemophilus influenzae, Pseudomonas aeruginosa, Klebsiella. Routes of penetration of pathogenic microorganisms to the middle ear area:

  • With a cough.
  • With sneezing.
  • With improper nose blowing.

In weakened women, infection of the middle ear cavity can occur hematogenously (through the bloodstream) or through a damaged eardrum.

Symptoms of otitis media may vary among patients. This also applies to pregnant women. For example, for some, the disease begins with fever, ear congestion, and headache. Others are bothered by shooting pains that are accompanied by purulent discharge. In the third case, other than discomfort in the ear and deterioration in general well-being, there are no signs.

Purulent otitis media

In this form of the disease, fever is accompanied by suppuration, and blood may be present. Due to inflammation, the middle ear fills with purulent contents, which burst through the eardrum. Once released, the pain usually subsides, the temperature returns to normal, and hearing is partially restored. The purulent form of the disease has two serious complications:

  • Complete destruction of the structures of the auditory sensory system with hearing loss or complete loss of hearing.
  • Spread of the process in the cranial cavity (infectious lesions of the membranes and brain tissue).

Despite the fact that inflammation in the ear itself is not dangerous for the fetus, the disease must be taken seriously. The infectious process can be complicated by the seizure of the entire hearing system, and then the treatment program will become significantly more complicated.

Symptoms of otitis media do not go away without leaving a trace. Any sign or slight suspicion of disease should be a reason to visit a doctor.

What procedures can be performed

Otitis media during pregnancy can be eliminated using physiotherapeutic procedures as an aid. Their advantage: a safe effect on the fetus, including in the early stages of embryo development. One option may be to blow out the ear canal, which helps open the Eustachian tube.

To combat the inflammatory process and increase blood circulation, pregnant women use pneumomassage of the eardrum. The procedure is performed by a qualified specialist using appropriate equipment or done manually.

Features of therapy in early and late stages

In the early stages of pregnancy, the safest method of treating otitis is the use of herbal medicines with a quality certificate. This form of treatment is not aggressive, but should still be carried out under the supervision of a doctor. Herbal medicines do not complicate the course of pregnancy and do not harm the intrauterine development of the child.

When the eardrum is not damaged, ear drops can be used, which have no contraindications for pregnant women.

During late pregnancy, otitis media can be treated with an integrated approach: safe medications, folk remedies and physiotherapeutic procedures. Antibiotics should be avoided, as they can cause hypoxia in a child.

First aid

To eliminate an acute attack, pregnant women are recommended to use traditional medicine methods. Can be used for a short time before the patient goes to a medical facility.

Safe methods for pregnant women.

  1. Warm olive oil. Place one drop in the affected ear. At this time, the expectant mother is in a supine position. Do not take if the eardrum is ruptured.
  2. Hold a bag of heated salt near your ear. It should be warm, but not hot. Not recommended for purulent disorders.
  3. Steam inhalations. They help reduce symptoms for a short time. Breathing warm steam is prohibited when the temperature rises.
  4. If the pain radiates to the head, you can wrap it in a towel previously soaked in cool water.

Treatment of otitis media during pregnancy should not be carried out using boric alcohol. This folk medicine tends to penetrate the placental barrier into breast milk.

If acute attacks occur, the influence of unfavorable factors on the fetus should be limited:

  • Take painkillers and antipyretic drugs in case of urgent need;
  • in the presence of pus, warming agents should not be used;
  • when going outside, you must cover your ear;
  • clean with caution, especially when there is discharge of pus;
  • the diet should contain a large amount of fruits and vegetables;
  • drink plenty of fluids.

In the presence of a chronic form, the symptoms are mild and appear in case of exacerbation.

Disease prevention

Pregnancy is the most crucial period in a woman’s life. She begins to take doubly care of her health, as a new life is born inside. Strengthening the immune system in preparation for conception and during pregnancy is the best disease prevention. If the expectant mother’s body is healthy, then it is able to resist infection by viral infections, which can lead, among other things, to the appearance of otitis media.

The most important thing is to adhere to a healthy lifestyle. Maintain proper and balanced nutrition. Provide your body with moderate physical activity, taking into account contraindications and timing of pregnancy.

A pregnant woman should not have any hypothermia. The expectant mother needs to protect her ears during the cold season. Avoid drafts, water entering the ear canals during swimming, and temperature changes.

When the likelihood of contracting ARVI and influenza increases, it is better for a pregnant woman to minimize travel in public transport and avoid large crowds of people and crowded places.

During the period of bearing a child, a woman must take care of her health with double force. No self-medication. If you experience any discomfort in the ear, you should seek help from a qualified doctor. To protect your child, carry and give birth to him healthy.


The pathology develops due to the penetration of infectious agents into the auditory canal. In pregnant women, the risk of otitis media is 3 times higher. This is associated with increased blood pressure and hormonal changes. As you know, during this period a large amount of progesterone is released in a woman’s body. This hormone is responsible for maintaining pregnancy throughout the entire 9 months. One of its effects is swelling of the mucous membranes of the upper respiratory tract. This fact is explained by the fact that progesterone causes fluid retention in the body of the expectant mother. Due to swelling of the mucous membranes of the paranasal sinuses, pharynx and eustachian tube, the ear canal narrows.

As a result of a violation of the ventilation function, fluid accumulates in the cavity of the middle ear - exudate. When it stagnates, the likelihood of infection increases. The penetration of bacterial or viral organisms into the ear canal leads to inflammation. The risk of developing otitis media during pregnancy is high in women suffering from upper respiratory tract diseases. Among them are pharyngitis, sinusitis, rhinitis. A possible cause of the development of otitis media is injury to the hearing organ, for example, due to improper cleaning of earwax.

The following risk factors are identified:

  • Marked decrease in immunity.
  • Chronic diseases of the ENT organs.
  • Ear injuries.
  • Visit to the swimming pool.
  • Infectious pathologies.

Pregnant women should take baths and swim in the pool with caution. If water gets into the narrowed ear canal, it will lead to fluid stagnation and infection. The penetration of bacteria most often causes purulent otitis media, which is characterized by more pronounced intoxication phenomena. In rare cases, microbes enter the ear hematogenously from other areas of inflammation. This occurs when an infection spreads throughout the body.

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