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Hemotympanum as a Complication of a Valsalva Maneuver during Childbirth

BACKGROUND: Hemotympanum may occur due to otic barotrauma secondary to Valsalva maneuver during the second phase of labor. A pressure differential across the tympanic membrane (TM) of about five psi can cause rupture. The increased intrathoracic and intraabdominal pressure spikes repeatedly manifest...

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Autores principales: Teitelbaum, Tali, Shochat, Isaac, Grinblat, Golda, Taha, Mohamad, Braverman, Itzhak
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10432077/
https://www.ncbi.nlm.nih.gov/pubmed/37593658
http://dx.doi.org/10.1155/2023/3328895
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author Teitelbaum, Tali
Shochat, Isaac
Grinblat, Golda
Taha, Mohamad
Braverman, Itzhak
author_facet Teitelbaum, Tali
Shochat, Isaac
Grinblat, Golda
Taha, Mohamad
Braverman, Itzhak
author_sort Teitelbaum, Tali
collection PubMed
description BACKGROUND: Hemotympanum may occur due to otic barotrauma secondary to Valsalva maneuver during the second phase of labor. A pressure differential across the tympanic membrane (TM) of about five psi can cause rupture. The increased intrathoracic and intraabdominal pressure spikes repeatedly manifested by “pushing” during second-stage labor easily approach (and may exceed) this level. Clinical Presentation. This case report describes a healthy thirty-seven-year-old multipara patient admitted for the 40-weeks' gestational age routine follow-up that proceeded to active labor followed by an aural fullness and bloody otorrhea. Otoscopic examination with a light microscope confirmed the hemotympanum of the right tympanic membrane. CONCLUSION: Forceful Valsalva can cause hemotympanum. Investigating the benefits and disadvantages of the pushing methods could help reduce such complications in the future. A prompt evaluation of an otolaryngologist should be requested in the event of a new postpartum hearing disturbance or bloody otorrhea.
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spelling pubmed-104320772023-08-17 Hemotympanum as a Complication of a Valsalva Maneuver during Childbirth Teitelbaum, Tali Shochat, Isaac Grinblat, Golda Taha, Mohamad Braverman, Itzhak Case Rep Otolaryngol Case Report BACKGROUND: Hemotympanum may occur due to otic barotrauma secondary to Valsalva maneuver during the second phase of labor. A pressure differential across the tympanic membrane (TM) of about five psi can cause rupture. The increased intrathoracic and intraabdominal pressure spikes repeatedly manifested by “pushing” during second-stage labor easily approach (and may exceed) this level. Clinical Presentation. This case report describes a healthy thirty-seven-year-old multipara patient admitted for the 40-weeks' gestational age routine follow-up that proceeded to active labor followed by an aural fullness and bloody otorrhea. Otoscopic examination with a light microscope confirmed the hemotympanum of the right tympanic membrane. CONCLUSION: Forceful Valsalva can cause hemotympanum. Investigating the benefits and disadvantages of the pushing methods could help reduce such complications in the future. A prompt evaluation of an otolaryngologist should be requested in the event of a new postpartum hearing disturbance or bloody otorrhea. Hindawi 2023-08-09 /pmc/articles/PMC10432077/ /pubmed/37593658 http://dx.doi.org/10.1155/2023/3328895 Text en Copyright © 2023 Tali Teitelbaum et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Teitelbaum, Tali
Shochat, Isaac
Grinblat, Golda
Taha, Mohamad
Braverman, Itzhak
Hemotympanum as a Complication of a Valsalva Maneuver during Childbirth
title Hemotympanum as a Complication of a Valsalva Maneuver during Childbirth
title_full Hemotympanum as a Complication of a Valsalva Maneuver during Childbirth
title_fullStr Hemotympanum as a Complication of a Valsalva Maneuver during Childbirth
title_full_unstemmed Hemotympanum as a Complication of a Valsalva Maneuver during Childbirth
title_short Hemotympanum as a Complication of a Valsalva Maneuver during Childbirth
title_sort hemotympanum as a complication of a valsalva maneuver during childbirth
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10432077/
https://www.ncbi.nlm.nih.gov/pubmed/37593658
http://dx.doi.org/10.1155/2023/3328895
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