Zusammenfassung
Während der Schwangerschaft nehmen etwa 85% aller Frauen mindestens ein Medikament ein. Dabei sind etwa 1% aller schwerwiegenden Fehlbildungen auf die Einnahme von embryotoxischen Medikamenten zurückzuführen. Da sowohl der HNO-Arzt als auch die Schwangere bei der Gabe von Medikamenten häufig unsicher sind, erfolgt die Therapie von spezifischen HNO-Problemen oft durch Gynäkologen. Anhand einer ausführlichen Literaturrecherche und unter Berücksichtigung der Empfehlungen der Roten Liste® des Bundesverbands der Pharmazeutischen Industrie e. V. und der US-amerikanischen Food and Drug Administration (FDA) werden in diesem Fortbildungsartikel typische Hals-Nasen-Ohren-ärztliche Erkrankungen aufgeführt und mögliche medikamentöse Therapien erörtert.
Abstract
Approximately 85% of pregnant woman receive at least one medical prescription during their gestation. One percent of major congenital malformations of the fetus are attributed to embryotoxic medication. Because ENT surgeons and pregnant women are often uncertain about proper medication, treatment of specific ENT problems is often provided by the obstetrician. Based on the current knowledge, PubMed research, and recommendations of the Red List (Rote Liste) of the German Pharmaceutical Industry and the FDA, medical treatment of ENT-specific diseases is discussed.
Literatur
Egen-Lappe V, Hasford J (2004) Drug prescription in pregnancy: analysis of a large statutory sickness fund population. Eur J Clin Pharmacol 60(9):659–666
Rubin PC, Craig GF, Gavin K, Sumner D (1986) Prospective survey of use of therapeutic drugs, alcohol, and cigarettes during pregnancy. Br Med J (Clin Res Ed) 292(6513):81–83
Ash P, Vennart J, Carter CO (1977) The incidence of hereditary disease in man. J Med Genet 14:305
Vlastarakos PV, Nikolopoulos TP, Manolopoulos L et al (2008) Treating common ear problems in pregnancy: what is safe? Eur Arch Otorhinolaryngol 265(2):139–145
Rote Liste® (2011) Arzneimittel in Schwangerschaft und Stillzeit, Beratungsstellen. Rote Liste® Service GmbH, Frankfurt/Main, S 2171
Gani Braida A, Lombardi C, Del Giudice A et al (2003) Rhinitis in pregnancy. Allerg Immunol (Paris) 35(8):306–313
Ellegard EK (2004) Clinical and pathogenetic characteristics of pregnancy rhinitis. Clin Rev Allergy Immunol 26(3):149–159
(o A) (2004) Gastroschisis and pseudoephedrine during pregnancy. Prescrire Int 13(72):141–143
Werler MM (2006) Teratogen update: pseudoephedrine. Birth Defects Res A Clin Mol Teratol 76(6):445–452
Torfs CP, Katz EA, Bateson TF et al (1996) Maternal medications and environmental exposures as risk factors for gastroschisis. Teratology 54(2):84–92
Werler MM, Mitchell AA, Shapiro S (1992) First trimester maternal medication use in relation to gastroschisis. Teratology 45(4):361–367
Mazzotta P, Loebstein R, Koren G (1999) Treating allergic rhinitis in pregnancy. Safety considerations. Drug Saf 20(4):361–375
Gilbert C, Mazzotta P, Loebstein R, Koren G (2005) Fetal safety of drugs used in the treatment of allergic rhinitis: a critical review. Drug Saf 28(8):707–719
Osur SL (2005) The management of asthma and rhinitis during pregnancy. J Womens Health (Larchmt) 14(3):263–276
Källén BA, Otterblad Olausson P (2003) Maternal drug use in early pregnancy and infant cardiovascular defect. Reprod Toxicol 17(3):255–261
Gluck PA, Gluck JC (2005) A review of pregnancy outcomes after exposure to orally inhaled or intranasal budesonide. Curr Med Res Opin 21(7):1075–1084
Keles N (2004) Treatment of allergic rhinitis during pregnancy. Am J Rhinol 18(1):23–28
Ostensen ME, Skomsvoll JF (2004) Anti-inflammatory pharmacotherapy during pregnancy. Expert Opin Pharmacother 5(3):571–580
Fardet L, Nizard J, Genereau T (2002) Non-selective and selective non-steroidal anti-inflammatory drugs, administration in pregnancy and breast feeding (article in French). Presse Med 31(31):1462–1468
Burdan F, Belzek A (2001) Current opinions on embryotoxic and teratogenic effects of ibuprofen (article in Polish/abstract). Pol Merkur Lekarski 11(63):266–270
Ostensen M (1998) Nonsteroidal anti-inflammatory drugs during pregnancy. Scand J Rheumatol Suppl 107:128–132
Ramsey-Goldman R, Schilling E (1997) Immunosuppressive drug use during pregnancy. Rheum Dis Clin North Am 23(1):149–167
Adams BK, Cydulka RK (2003) Asthma evaluation and management. Emerg Med Clin North Am 21(2):315–330
Dombrowski MP (1997) Pharmacologic therapy of asthma during pregnancy. Obstet Gynecol Clin North Am 24(3):559–574
Lockshin MD, Sammaritano LR (1998) Corticosteroids during pregnancy. Scand J Rheumatol Suppl 107:136–138
Haas A, Maschmeyer G (2008) Antibiotikatherapie in der Schwangerschaft. Dtsch Med Wochenschr 133:511–515
Shehata H, Nelson-Piercy C (2001) Drugs to avoid. Best Pract Res Clin Obstet Gynaecol 15(6):971–986
Briggs GG (1998) Tetracycline: effect on fetal bone growth. J Am Pharm Assoc 38(6):717–727
Rote Liste® (2012) Aciclovir. http://www.rote-liste.de/
Haddad J, Messer J, Willard D, Ritter J (1989) Acyclovir and pregnancy: current aspects (article in French). J Gynecol Obstet Biol Reprod (Paris) 18(5):679–683
Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V. (2010) Leitlinie „ Hörsturz (Akuter idiopathischer sensorineuraler Hörverlust)“. AWMF online. http://www.awmf.org/leitlinien. Zugegriffen: 22.03.12
Hellebrand MC, Friebe-Hoffmann U, Bender HG et al (2006) Mona Lisa syndrome: idiopathic facial paralysis during pregnancy. Z Geburtshilfe Neonatol 210(4):126–134
Leathem AM (1986) Safety and efficacy of antiemetics used to treat nausea and vomiting in pregnancy. Clin Pharm 5(8):660–668
Schroder O, Stein J (2002) Vomiting in pregnancy. When is it more than only a bothersome nuisance? (article in German). MMW Fortschr Med 144(50):32–34
Cohen-Kerem R, Railton C, Oren D et al (2005) Pregnancy outcome following non-obstetric surgical intervention. Am J Surg 190(3):467–473
Interessenkonflikt
Die korrespondierende Autorin gibt für sich und ihren Koautor an, dass kein Interessenkonflikt besteht.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Gronau, S., Neumann, A. Medikamentöse Therapie während der Schwangerschaft. HNO 60, 637–650 (2012). https://doi.org/10.1007/s00106-012-2517-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00106-012-2517-y