Pregnancy rhinitis

Introduction:

Nasal congestion is common in pregnancy. It goes by the name pregnancy rhinitis. This condition is so common that it is seen in one in five pregnancies.

Clinical features:

Nasal congestion

Rhinorrhoea

These symptoms are aggravated by using nasal decongestant nasal sprays.

Definition:

Ellegard defined pregnancy rhinitis as nasal congestion which occurs during the last 6 weeks of pregnancy without other signs of upper respiratory infections / allergy. This disappears completely within 2 weeks after delivery.

Etiology:

1. Could be due to hormone effects
2. Elevated placental growth hormones have been implicated
3. Smoking is considered to be a risk factor
4. Autonomic nervous system imbalance as it occurs in vasomotor rhinitis

Diagnosis:

1. Watery rhinorrhoea
2. Nasal congestion
3. Secondary infections of paranasal sinuses

Management:

1. Reassurance
2. Elevation of head end during sleep
3. Ensuring normal humidity in the inspired air
4. Adequate hydration
5. Instillation of saline nasal drops
6. Mild to moderate exercise will reduce nasal congestion
7. Pseudoephidrine is the preferred decongestant used during prenancy if situation warrants
8. Minimally invasive surgical procedures like cauterizing the enlarged inferior turbinates can help in some cases.