# Gestational Neuro-Otological Manifestation Patterns Across Trimesters in Karachi, Pakistan: A Retrospective Cross-Sectional Study

## TL;DR

This study examines how neuro-otological symptoms like tinnitus and vertigo change during pregnancy, finding they increase in the third trimester.

## Contribution

The study identifies trimester-specific trends in neuro-otological symptoms among pregnant women in Karachi, Pakistan.

## Key findings

- Otological complaints affected 71% of pregnant women, with tinnitus and ear fullness being most common.
- Neurological and vestibular symptoms occurred in 69% of participants, with vertigo, headache, and dizziness being most frequent.
- Symptoms increased significantly with advancing gestational age, peaking in the third trimester.

## Abstract

Objective: To determine the prevalence and trimester-specific trends of neuro-otological manifestations among pregnant women attending antenatal care in tertiary care hospitals at Karachi, Pakistan.

Methodology: A prospective, multicenter observational study was conducted from January 2020 to December 2024 at two tertiary hospitals in Karachi. A total of 1,230 pregnant women aged 18-45 years were enrolled through non-probability consecutive sampling. Data were collected using a validated three-part assessment tool encompassing demographic characteristics, otological symptoms, and neurological/vestibular presentations. Statistical analysis was performed using SPSS software version 26 (IBM Corp., Armonk, NY). Chi-square and Fisher’s exact tests were applied, with significance defined as P < 0.05.

Results: Neuro-otological symptoms were highly prevalent. Otological complaints were reported in 874 (71%) participants, most commonly tinnitus in 390 (31.7%) and ear fullness in 310 (25.2% ). Neurological and vestibular manifestations were observed in 847 (69%), with vertigo (304, 24.7%), headache (260, 21.1%), and dizziness (215, 17.5%) being the most frequent. A significant increase in the frequency of symptoms was noted with advancing gestational age, with the third trimester demonstrating the highest burden across most manifestations (P < 0.001).

Conclusions: Neuro-otological manifestations are common during pregnancy and exhibit a trimester-dependent rise, peaking in late gestation. Routine screening and early recognition within antenatal care may help prevent misdiagnosis, reduce patient distress, and improve maternal quality of life.