Tonsillitis in pregnancy

Overview

Tonsillitis is a swelling of the tonsils, which are the two small lumps at the back of your throat. When you are pregnant, your immune system changes, which can make you more likely to get infections like tonsillitis. It is usually caused by a virus, but bacteria can sometimes be the cause.

Yes, tonsillitis is quite common in pregnancy. The changes in your immune system and increased stress on your body can make you more likely to catch infections like sore throats and tonsillitis.

It affects pregnant women of any age, especially during the first and second trimesters when immune changes are most pronounced.

Symptoms

Common symptoms

• Sore throat that makes it painful to swallow
• Red, swollen tonsils that may have white or yellow spots
• Fever (temperature over 38°C / 100.4°F)
• Swollen, tender glands in your neck
• Headache
• Feeling tired and achy

Symptoms in children

• Children may also experience stomach pain, nausea, or vomiting
• They might drool more than usual because swallowing hurts

Symptoms in older adults

• Older adults may have a higher fever and feel very weak
• They are more likely to have complications like dehydration or difficulty breathing

Causes

Main causes

• Viruses – the same viruses that cause the common cold or flu
• Bacteria – most often group A streptococcus (strep throat)

Risk factors

• Being pregnant, because your immune system changes
• Close contact with someone who has a sore throat or cold
• Smoking or being around smoke
• Weakened immune system from other conditions or stress

When to see a doctor

See a doctor urgently if:

• If you have trouble breathing or swallowing
• If you have a very high fever that doesn’t come down with home care
• If you are unable to keep fluids down and are worried about dehydration

Book a routine appointment if:

• If your sore throat lasts more than 2 days without getting better
• If you have white spots on your tonsils or swollen neck glands that are painful
• If you have had recurrent tonsillitis before or during pregnancy

Diagnosis

Your doctor will ask about your symptoms and look at your throat and tonsils. They may also feel the glands in your neck.

Tests that may be done

• Throat swab – a cotton swab gently rubbed on your tonsils to test for bacteria like strep
• Rapid strep test – gives results in minutes
• A throat culture that takes a day or two

What to expect at your appointment

The diagnosis is usually quick and simple. The doctor will check your temperature, look at your throat, and possibly take a swab. This is not painful, just a little uncomfortable for a second.

Treatment

Treatment depends on whether the cause is viral or bacterial. For viral tonsillitis, the focus is on rest and home care. For bacterial tonsillitis, your doctor can prescribe antibiotics that are safe to use during pregnancy. You should not take any medicine without checking with your doctor or pharmacist first.

Self-care at home

• Get plenty of rest – your body needs energy to fight the infection.
• Drink lots of fluids like water, warm tea, or soup to stay hydrated.
• Gargle with warm salt water (half a teaspoon of salt in a glass of warm water) several times a day.
• Eat soft, soothing foods like yogurt, mashed potatoes, or smoothies. Avoid spicy, acidic, or very hot foods.
• Use a cool-mist humidifier in your room to ease throat dryness.

Medical treatments

Your doctor or pharmacist can recommend over-the-counter pain relievers that are considered safe during pregnancy. If a bacterial infection is confirmed, they will prescribe an antibiotic that is known to be safe for you and your baby. Always take the full course as prescribed, even if you start feeling better.

When is surgery considered?

Surgery to remove the tonsils (tonsillectomy) is very rarely done during pregnancy. It is usually postponed until after the baby is born, unless there is a very serious complication like an abscess that does not drain or frequent severe infections that put the pregnancy at risk.

Living with this condition

While you are sick, take it easy. Rest as much as you can, and drink small amounts of fluid often. You can use a warm compress on your neck if it feels sore. Let your partner, family, or friends help with daily tasks so you can recover.

Lifestyle tips

• Avoid smoking and second-hand smoke – they can make your sore throat worse.
• Use a clean, soft towel and do not share cups or utensils with others to prevent spreading the infection.
• Get fresh air and light activity if you feel up to it – walking around the house is fine, but avoid heavy exercise until you are well.

Diet and exercise

Eat soft, bland foods that are easy to swallow, like oatmeal, applesauce, or scrambled eggs. Drink warm fluids like herbal tea with honey (if you are not allergic). Avoid citrus fruits, spicy foods, and very hot or cold drinks. Light stretching or walking is okay, but listen to your body and rest when you need to.

Mental health and emotional wellbeing

Being sick during pregnancy can be stressful and worrying. You may feel anxious about the infection harming your baby, or frustrated that you cannot take your usual medicines. It is normal to feel this way. Talk to your partner, a friend, or your healthcare provider about your concerns.

Prevention

You cannot always prevent tonsillitis, but you can reduce your risk. Wash your hands often with soap and water, especially after being in public places or around people who are sick. Avoid touching your face, and stay away from people who have a sore throat or cold.

Vaccines

There is no vaccine specifically for tonsillitis, but getting the flu vaccine (which is safe during pregnancy) can help prevent viral infections that might lead to tonsillitis. Talk to your doctor about which vaccines are recommended during pregnancy.

Screening programmes

There is no routine screening for tonsillitis. If you have symptoms, you should see your doctor for evaluation.

Complications

If left untreated

• The infection could spread to nearby areas, such as the ear or sinuses, or cause a peritonsillar abscess (a pocket of pus behind the tonsil).
• Dehydration is a risk if you cannot drink enough fluids because of pain.
• In rare cases, a severe bacterial infection could lead to more serious problems like rheumatic fever or kidney inflammation.

Long-term outlook

The outlook is very good. Most cases of tonsillitis in pregnancy clear up with rest and home care. Even if you need antibiotics, they are safe and effective. With proper treatment, you and your baby will be fine. Your doctor will monitor you to make sure you recover completely.

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