Management of vertigo in pregnancy

Background. Pregnancy is a specific female physiological period characterized by significant changes, included oto-logical and neurotological manifestations. Vestibular disorders like vertigo and dizziness, are common complaints from pregnant women to primary care. Objectives. The aim of this paper is to describe clinical pictures, evaluation methods and therapeutic options of acute vertigo in pregnancy with the related pathogenetic hypotheses. Method. We describe 11 cases of vertigo in pregnancy. All patients underwent audio-vestibular evaluation, consisting of pure-tone audiometry, impedance and clinical testing of the vestibular function, the “bed side examination”. Results. Audiological evaluation showed normal pure-tone audiometry and impedance in 10 patients. Only in one case a sudden right total deafness was highlighted with vestibular areflexia, showing a secondary positional vertigo. Seven patients presented a benign paroxysmal positional vertigo (BPPV) effectively treated by liberatory maneuvers. Three patients had a diagnosis of vestibular neuritis and they were treated with corticosteroids therapy with a complete resolution of dizziness and vertigo in one month. Conclusions. Our results point out the importance of multidisciplinarity between otolaryngologist, neurologist and gynecologist. From a pathogenic point of view, the vascular etiology, strictly related to the gravidic hormonal variations, is often hypothesized.