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Role of ent in perinatal period
Role of ent in perinatal period
Role of ent in perinatal period
Role of ent in perinatal period
Role of ent in perinatal period
Role of ent in perinatal period
Role of ent in perinatal period
Role of ent in perinatal period
Role of ent in perinatal period
Role of ent in perinatal period
Role of ent in perinatal period
Role of ent in perinatal period
Role of ent in perinatal period
Role of ent in perinatal period
Role of ent in perinatal period
Role of ent in perinatal period
Role of ent in perinatal period
Role of ent in perinatal period
Role of ent in perinatal period
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Role of ent in perinatal period

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  1. ROLE OF ENT IN PERINATAL PERIOD Dr Sheelu Srinivas Consultant ENT Surgeon Fortis Hospitals Bannerghetta Road
  2. Newborn Hearing Screening Programme <ul><li>OTOLARYNGOLOGIC MANIFESTATIONS OF PREGNANCY </li></ul>
  3. OTOLARYNGOLOGIC MANIFESTATIONS OF PREGNANCY <ul><li>Metabolic and physiologic changes during pregnancy </li></ul><ul><li>– Hearing & Balance </li></ul><ul><ul><li>– Bell's palsy </li></ul></ul><ul><ul><li>– Nasal symptoms </li></ul></ul><ul><ul><li>– Oral manifestations </li></ul></ul><ul><ul><li>– Aero digestive tract </li></ul></ul><ul><ul><li>– Thyroid </li></ul></ul><ul><ul><li>– Dermatologic manifestations </li></ul></ul>
  4. Rhinitis During Pregnancy : <ul><li>Other underlying conditions – Allergic rhinitis – Rhinitis medicamentosa – Bacterial rhinosinusitis – Vasomotor rhinitis – Nasal polyps – Deviated septum </li></ul>
  5. RHINITIS RX <ul><li>AVOID TOPICAL DECONGESTANTS & SPRAY </li></ul><ul><li>SALINE NASAL SPRAY </li></ul><ul><li>Environmental control </li></ul><ul><li>Antihistamines: chlorpheniramine (cat. B) </li></ul><ul><li>Loratidine and cetirizine (cat. B)• Only after 1st trimester </li></ul><ul><li>Intranasal corticosteroids </li></ul>
  6. Gastro esophageal Reflux <ul><li>Reflux • 50-75% of gravid women • Heartburn, sore throat, hoarseness • Third trimester– Increased abdominal pressure – Decreased gastric emptying – Increased intestinal transit time? – Decreased LES pressure </li></ul>
  7. Gastro esophageal Reflux <ul><li>Antireflux precautions, frequent small meals </li></ul><ul><li>Antacids, Sucralfate </li></ul><ul><ul><li>• H2 Blockers:– Cimetidine . Ranitidine - OK </li></ul></ul><ul><ul><li>• Proton pump inhibitors - after 1st trimester– </li></ul></ul>
  8. Why newborn hearing screening? <ul><li>Two to four newborns, out of every 1,000, have hearing deficiency </li></ul><ul><li>among the high-risk babies, the number of hearing-impaired is 5 to 14 per cent. </li></ul><ul><li>High-riskers include those </li></ul><ul><li>birth weight was </li></ul><ul><li>less than 1.5 kg; </li></ul><ul><li>jaundice, </li></ul><ul><li>meningitis or birth asphyxia; </li></ul><ul><li>ventilation after birth; </li></ul><ul><li>family history of hearing loss </li></ul>
  9. It is estimated to be 30 times more common than other congenital defects, such as sickle cell anemia, cystic fibrosis, hypothyroidism, etc. <ul><li>Deafness is one of the commonest congenital disabilities in the world. </li></ul>
  10. Do we need a test? <ul><li>Initially, babies who are born with hearing loss do not look or behave any differently from babies who are hearing.  </li></ul><ul><li>However, undetected and untreated hearing loss has serious consequences on the acquisition of language skills as well as cognition and emotional and social development. </li></ul><ul><li>The first 6 months of a baby’s life are very crucial for the development of speech and language.   </li></ul>
  11. When? <ul><li>The hearing screen is usually done before you leave the maternity unit. </li></ul>
  12. What does it involve? <ul><li>A soft tip ear piece is placed in outer part of babies ear. </li></ul><ul><li>It sends clicking sounds down the ear </li></ul><ul><li>When an ear receives sound –cochlea responds with echo </li></ul><ul><li>Screening equipment picks up this response </li></ul>
  13. Results <ul><li>Given immediately </li></ul><ul><li>Either Pass/Refer </li></ul><ul><li>Even though child passes if he is a high risker further assessment done </li></ul><ul><li>Up to 3 years ,every 6 months </li></ul>
  14. What if no response ? <ul><li>Second test in a week </li></ul><ul><li>Causes- baby unsettled, background noises, ear fluid </li></ul>
  15. Second test <ul><li>Similar to first </li></ul><ul><li>ABR/BERA </li></ul>
  16. Do tests hurt? <ul><li>No </li></ul><ul><li>Soft tips/soft head phones </li></ul><ul><li>Keep child comfortable </li></ul><ul><li>Feed before test </li></ul><ul><li>Carry things to make comfortable </li></ul>
  17. Is this universally available <ul><li>Not in India </li></ul><ul><li>  In most of the States in the U.S./UK/Europe, for instance, the neo-natal hearing testing is compulsory by law and the protocol is called `1-3-6' (meaning, all babies should have their hearing screened by the first month; diagnosed by the third month and be receiving hearing aids by six months.) </li></ul>
  18. Is the test compulsory? <ul><li>Definitely for high risk baby </li></ul><ul><li>who may have passed the hearing screening should, nonetheless, receive audiologic monitoring every 6 months until age 3 years </li></ul>
  19. THANK YOU

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