Hoarseness: consider laryngopathia gravidarum – caused by changes in the fluid content of the lamina propria just beneath the laryngeal mucosa.¹⁶ Symptoms include hoarseness, voice loss, deeper voice, and diminished range of pitch.¹⁷ Treatment is supportive with hydration, and singers are encouraged to refrain from singing. Symptoms typically resolve postpartum.

Thyroid Nodules: Diffuse thyroid enlargement during pregnancy occurs in up to 50% of pregnant women. Growth of existing nodules and new nodule formation may also occur during pregnancy.¹⁸ Initial TSH may be helpful, but generally these patients, if stable, are referred for outpatient work-up.

Patient ed

Patient instructions such as this may be distributed: www.babycenter.com/0_stuffy-nose-during-pregnancy_1076.bc

Dr. Roemer is an adjunct associate professor in the Department of Emergency Medicine at the OU School of Community Medicine, Schusterman Center, Tulsa, Okla.; Dr. Martinez is a resident emergency physician in the Department of Emergency Medicine, OU School of Community Medicine, Tulsa, Okla.; Dr. Katz is a clinical professor, Department of OB-GYN, Oregon Health Sciences University, and Medical Director, Women’s Services, Sacred Heart Medical Center, Center for Genetics and Maternal-Fetal Medicine, Eugene, Ore.; and Dr. Riggs is a resident in the Department of Otorhinolaryngology, OU Health Sciences Center, Oklahoma City, Okla.

References

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