• Contact us
• About us
• A-Z topics
• Symptom Checker
• Service Finder
• Linking to us
• Information partners
• Terms of use
• Privacy

Pregnancy, Birth and Baby is funded by the Australian Government and operated by Healthdirect Australia.

Pregnancy, Birth and Baby is provided on behalf of the Department of Health

Pregnancy, Birth and Baby’s information and advice are developed and managed within a rigorous clinical governance framework. This website is certified by the Health On The Net (HON) foundation, the standard for trustworthy health information.

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

This information is for your general information and use only and is not intended to be used as medical advice and should not be used to diagnose, treat, cure or prevent any medical condition, nor should it be used for therapeutic purposes.

The information is not a substitute for independent professional advice and should not be used as an alternative to professional health care. If you have a particular medical problem, please consult a healthcare professional.

Except as permitted under the Copyright Act 1968, this publication or any part of it may not be reproduced, altered, adapted, stored and/or distributed in any form or by any means without the prior written permission of Healthdirect Australia.

Support this browser is being discontinued for Pregnancy, Birth and Baby

Support for this browser is being discontinued for this site

• Internet Explorer 11 and lower

We currently support Microsoft Edge, Chrome, Firefox and Safari. For more information, please visit the links below:

• Chrome by Google
• Firefox by Mozilla
• Microsoft Edge
• Safari by Apple

You are welcome to continue browsing this site with this browser. Some features, tools or interaction may not work correctly.

Baby (and tissues!) on board: Tips for managing pregnancy rhinitis | Your Pregnancy Matters

×

Refine your search: Find a Doctor Search Conditions & Treatments Find a Location

Appointment New Patient Appointment
or Call214-645-8300

MedBlog

Your Pregnancy Matters

October 6, 2020

Your Pregnancy Matters

Robyn Horsager-Boehrer, M. D. Obstetrics and Gynecology

When you think of side effects or symptoms brought on by pregnancy, nasal congestion and runny nose are not typically among the first to come to mind.

But maybe they should. Having a stuffy nose, difficulty breathing or sleeping, and snoring when pregnant can be alarming, especially amid the COVID-19 pandemic and the start of flu season.

Pregnancy rhinitis, also called gestational rhinitis, is a common ailment in the second and third trimesters, affecting approximately 20% of women. Characterized by inflammation and swelling of the mucous membranes in the nose, pregnancy rhinitis symptoms include congestion (nasal obstruction), sneezing, postnasal drip, and runny nose. These symptoms can also lead to poor sleep when your growing belly might already be making it difficult to rest.

All these issues can dramatically affect your mood and quality of life. The good news is that, for most patients, pregnancy rhinitis is temporary and there are safe, effective treatments available.

I've invited my colleague, Ashleigh Halderman, M.D., an ear, nose, and throat specialist at UT Southwestern to explain in more detail the causes of pregnancy rhinitis and how patients can manage their symptoms.

What causes pregnancy rhinitis?

The root cause of rhinitis can be allergic (affected by environmental irritants) or non-allergic (caused by infection). However, we are still learning how rhinitis is related to pregnancy.

We know that smoking, as well as having chronic rhinitis before pregnancy, predisposes patients to developing pregnancy rhinitis. Research suggests a few more potential causes:

• Having extra fluid in the body: During pregnancy, the body makes more blood and fluids, which can cause swelling, even in unexpected places such as the nasal passages. Blood vessels in the nose can swell with this additional volume, causing stuffiness.
• Higher levels of estrogen: Estrogen in older formulations of birth control pills has been associated with a side effect of nasal obstruction. However, in studies of the menstrual cycle, we don't see congestion with fluctuating estrogen levels. So, the connection remains unclear for now.
• Creation of human growth hormone: The placenta creates a variant of the human growth hormone (HGH), which has been associated with nasal symptoms in other conditions. For example, tumors that grow on the pituitary glands secrete growth hormones, which can cause severe nasal congestion.

Gestational rhinitis is under-researched. Data to date suggest no known association of rhinitis with pre-existing asthma, maternal age, duration of pregnancy, or the number of times a patient has been pregnant. However, a recent study found that patients carrying female babies were diagnosed significantly more often than patients carrying male babies.

Related reading: How to manage allergies and asthma during pregnancy

How long do symptoms last?

The annoying, uncomfortable symptoms of pregnancy rhinitis typically last six weeks or longer. For most patients, symptoms typically resolve two weeks after delivery.

Approximately a third of patients who had chronic rhinitis before pregnancy will have the same level of symptoms during, and a third will experience worsening of rhinitis symptoms. However, the remaining third will have less severe or no symptoms during pregnancy. I've had many women tell me they've felt the best, sinus-wise, when they were pregnant. However, there's no specific reason why this occurs.

Related reading: 5 weird pregnancy symptoms you might not know about

What treatments are available?

The first step toward relief is a visit with your doctor to rule out infection, such as COVID-19, influenza, or sinusitis. We may also recommend testing for concerns such as sinusitis or pregnancy tumor (pyogenic granuloma) – a non-cancerous growth of blood vessels that may appear during pregnancy.

From there, your doctor and Ob/Gyn may suggest:

• Getting regular exercise: Working out has been shown to significantly help relieve nasal congestion and regulate the sleep cycle. All the more reason to bust a move during pregnancy!
• Elevating your mattress: Try positioning the mattress so your whole body is situated at a 45-degree angle. While not widely studied, patients have reported that this helps clear the nasal passages enough to sleep.
• Using a humidifier: Adding a little moisture to the air can help alleviate nasal irritation. Many patients use them at night to wake up feeling less stuffy.
• Trying a sinus wash: Nasal saline sprays or sinus irrigation systems such as a neti pot can help clear the sinuses. Make sure to use distilled or boiled (and cooled) water – using water straight from the tap is not recommended.

Topical decongestants such as Afrin can be incredibly and immediately effective, but there is a risk of dependency. If you use this type of treatment more than once or twice a week, your nose can become "addicted" to it, which can lead to rhinitis medicamentosa – the spray will stop working as well, and your symptoms may get worse. Also, unlike gestational rhinitis, rhinitis medicamentosa won’t resolve after you deliver. It will only resolve when you stop using topical decongestants.

In general, pregnant patients can take decongestants that include pseudoephedrine as directed. However, we always recommend talking with your Ob/Gyn first, especially if you have high blood pressure.

Your Ob/Gyn might also recommend a steroid nasal spray, such as Flonase or Rhinocort, for severe symptoms. If you were using a spray to manage chronic rhinitis prior to pregnancy, your Ob/Gyn might advise you to keep using it during pregnancy. It is generally considered safe to use these products while breastfeeding, under your Ob/Gyn's guidance.

Your body will change in interesting ways during pregnancy. If you have new or unusual symptoms, call your doctor. We'll help you sort out what's normal from what could be a sinus infection or respiratory illness.

To talk with a doctor about nasal symptoms during pregnancy, call 214-645-8300 or request an appointment online.

More in: Your Pregnancy Matters

Your Pregnancy Matters

• Robyn Horsager-Boehrer, M.D.

December 20, 2022

Your Pregnancy Matters

• Robyn Horsager-Boehrer, M. D.

December 13, 2022

Pediatrics; Your Pregnancy Matters

• Jessica Morse, M.D.

December 6, 2022

Your Pregnancy Matters

• Shivani Patel, M. D.

November 22, 2022

Your Pregnancy Matters

• Robyn Horsager-Boehrer, M.D.

November 15, 2022

Your Pregnancy Matters

• Robyn Horsager-Boehrer, M.D.

November 7, 2022

Mental Health; Your Pregnancy Matters

• Robyn Horsager-Boehrer, M. D.

October 11, 2022

Prevention; Your Pregnancy Matters

• Robyn Horsager-Boehrer, M.D.

October 4, 2022

Mental Health; Your Pregnancy Matters

• Meitra Doty, M. D.

September 27, 2022

More Articles

Allergic rhinitis during pregnancy: description of the disease, causes, symptoms, cost of treatment in Moscow

Allergic rhinitis during pregnancy is not uncommon, as the woman's body begins to react more violently to any irritants due to the peculiarities of the hormonal background and some disturbances in the functioning of the nasal mucosa. Most often, before pregnancy, the woman did not have a negative reaction to substances that become irritants when carrying a child. The disease usually debuts abruptly and unexpectedly. Since the condition of a woman with such a phenomenon worsens, it is imperative that when rhinitis appears, it is necessary to seek medical help. It is strictly forbidden to treat the disease on your own due to the fact that serious harm to the fetus can be caused by errors in therapy. Any treatment should be coordinated with the gynecologist who is leading the pregnancy. nine0003

Rhinitis of an allergic nature during pregnancy is primarily due to hormonal changes and features of the immune system. In this case, an unpleasant phenomenon can occur both from the very first day after conception, and after a few months of gestation. According to medical statistics, every third woman suffers from such a disorder during pregnancy. In most cases, after childbirth, rhinitis goes away, and what was an allergen again begins to be normally tolerated by the body. If allergic rhinitis develops during pregnancy, treatment should be mandatory. nine0003

There is usually only one allergen during pregnancy. Intolerance to two or more substances, if it was not previously, is considered an exceptional phenomenon. The most harmless is an allergy to cold, in which rhinitis develops only on the street during the cold season and completely disappears indoors. This form of the disease is not so dangerous, as it is present sporadically and for a short time. With it, the risk of complications is extremely small, and it does not greatly disturb the general condition.

Major irritants

Doctors were able to determine which irritants most often provoke allergic rhinitis. This greatly helps in the treatment of the disease, as it simplifies the process of determining the allergen, the effect of which should be minimized as much as possible.

Allergic rhinitis develops at the moment when an irritant enters the mucous membrane. Due to its presence, inflammation of the mucosa occurs and, as a result, its swelling. The body, in order to get rid of the allergen, begins to secrete a large amount of especially liquid mucus, which should wash it out. Due to the fact that the allergen is constantly supplied with air, it cannot be removed naturally. As a result, it is impossible to solve the problem of allergic rhinitis without drugs. nine0003

The main allergens that can cause problems in pregnant women are:

• pollen of plants and their seeds - they are the cause of rhinitis in the warm season. With these irritants, health may remain unsatisfactory until the very end of the growing season of plants;

• smoke from cigarettes or wood - such irritants usually begin to cause damage to health if a woman lives in an area with unfavorable environmental conditions; nine0003

• Dust - it is not the dust itself that causes allergies, but the dust mites that live in it. Because of this, a negative reaction of the body also occurs when using down pillows and blankets, in which there are ideal conditions for the life of dust mites;

• air fresheners and deodorants - they contain a large number of aggressive chemical components that can cause allergies even in non-pregnant women, and when carrying a child, they almost always provoke a runny nose; nine0003

• animal hair and bird feathers - sometimes during pregnancy, an allergy to pets can develop, although there were no negative consequences from their stay in the house before. To solve the problem, the animal, which has become a source of irritants, must be isolated from the woman in another room until the birth of the child and minimize her contact with him.

Whatever the cause of the disease, it is necessary to carry out treatment with the involvement of a specialist. Self-medication during pregnancy is extremely dangerous and can lead to irreversible negative consequences. nine0003

Quite often, before an allergic rhinitis occurs, a woman has a simple catarrhal rhinitis. During pregnancy, it is this form of the disease that often becomes the impetus for the development of a pathological process, in which something will no longer be tolerated by the body.

At what time is the disease especially dangerous

Depending on how pregnant a woman is, allergic rhinitis poses a greater or lesser danger. The most serious problem is the problem that occurs in the first trimester of pregnancy. At this moment, all systems and organs of the unborn child are laid, and with a lack of oxygen in the blood, especially severe congenital malformations or intrauterine death of the fetus can occur. When a woman in the first trimester does not pay attention to her well-being and does not treat allergic rhinitis, the risk of miscarriage increases many times due to respiratory failure at night. If allergic rhinitis is present in pregnant women, only a doctor will determine how to treat it. nine0003

In the second and third trimester, the lack of oxygen in the mother's blood also does not benefit the child. However, due to the enlarged belly, a woman can only sleep on her side (otherwise she is uncomfortable), respiratory disorders are not so strong and threaten deformities to a lesser extent. At the same time, if you do not start treatment, the symptoms of rhinitis will increase and nasal congestion will constantly disturb. This is already dangerous for the child and can even cause premature birth against the background of general hypoxia of the mother and fetus. nine0003

Forecast

In the event that attention was paid to allergic rhinitis in pregnant women in a timely manner, the prognosis is positive. The violation can be effectively dealt with with the help of drugs allowed during this period, and then the risk of harm to the mother and fetus when an allergy appears will be eliminated. The doctor, if necessary, will adjust the treatment and will be able to build it so that there are no negative side effects of therapy.

If therapy is not started on time and severe fetal hypoxia is already present, then the prognosis is usually considered difficult, since this condition does not pass without a trace for the unborn child. Also, the prognosis will be unfavorable if the treatment was carried out on its own without the involvement of a specialist. In such a situation, there is a risk of serious consequences for the child, due to the fact that the mother used the wrong drugs. nine0003

Differences from colds

There are certain signs that even allow you to independently understand whether a cold or an allergic cause has a runny nose. The main distinguishing feature is that the snot in case of an allergic disorder is liquid, transparent, more like water. If the disease is cold, then the discharge becomes thick, green or yellow-green. They may also have a strong odor. In addition, with a cold, there is an increase in temperature, but not with an allergic one. nine0003

Rhinitis in pregnancy

Otorhinolaryngologist, surgeon at GMS Clinic Oleg Abramov talks in his article about rhinitis of pregnancy (hereinafter referred to as RH).

It was no coincidence that I chose this topic after a series of publications on the social network about allergic rhinitis (hereinafter referred to as AR), as recent studies note that although the cause of RB is not completely clear, the combination of AR, which is especially poorly controlled together with RB, can lead to severe nasal congestion, to insufficient oxygen supply, and, as a result, to increased fatigue, irritability, frequent SARS, sleep disturbance, which can certainly affect the development of the fetus. Moreover, the presence of AR is associated with snoring in women during pregnancy, and together they can provoke the development of sleep apnea syndrome (stopping breathing during sleep), which leads to arterial hypertension, preeclampsia, slowed fetal growth and low Apgar scores. Therefore, the relevance of this problem is only growing. nine0003

Definition and concept

Rhinitis of pregnancy is a disease accompanied by nasal congestion and discharge, periodic sneezing without signs of inflammation, allergies, or other causes. This condition can occur in any trimester of pregnancy and usually resolves within two weeks after delivery.

Occurrence

Nasal congestion is a very common problem during pregnancy (occurs in about 65% of cases), which can occur due to various reasons. RB, according to various sources, occurs in 9-40% of cases, and in one of the last observations there is an increasing incidence, that is, most of all RB is observed in the 3rd trimester - 38.9%, including those who did not have problems in the 1st and 2nd trimesters.

Causes and mechanism of occurrence

The mechanism of occurrence is not fully understood, and it is believed that RB occurs due to hormonal changes, in particular, under the influence of progesterone, estrogen, hCG and other hormones, the concentration of which gradually increases during pregnancy. Some authors believe that the occurrence of RB is associated with the worsening of concomitant AR. Some studies show that hormonal action leads to relaxation of the smooth muscles that make up the vessel wall of the nasal mucosa, resulting in nasal congestion. Such findings are supported by other studies that show that oral contraceptives cause similar effects in the nasal cavity (but not in everyone). Other studies show that elevated body mass index, overweight, multiple pregnancies provoke or aggravate RB. nine0003

Progression and potential risks

RB, in the absence of adequate treatment, has an adverse effect on the course of pregnancy and can lead to the development of rhinosinusitis, which is especially difficult to tolerate in the 3rd trimester. On the other hand, pregnancy is a special period in a woman's life, during which a large number of drugs are prohibited, and ENT pathologies, these restrictions have not been spared either. Very often I hear at the reception: "Doctor, I'm pregnant and I've been suffering with my nose all this time, but the doctors tell me - there's nothing to be done, I need to endure it. " On the other hand, the opposite situation is often observed: “Doctor, I am pregnant and I cannot live without vasoconstrictor drops.” These situations, of course, are not correct, since on the one hand there is a way out and optimal treatment, and on the other hand, constant exposure to vasoconstrictor drugs is not a way out of the situation at all. nine0003

Diagnostics

At the moment, there is no specific test to confirm or exclude RB. The diagnosis is made on the basis of the patient's complaints and the exclusion of other pathologies of the nasal cavity.

Choice of therapeutic tactics

Saline solutions

Before considering more serious medications, we should start with our favorite saline solutions. It should be noted that we are not talking about ordinary saline solutions, but hypertonic saline solutions (with an increased salt content, approximately 19-23 g/l). Such sprays are sold in all pharmacies, but they will not be sold to you right away (you need to ask). Several studies have noted significant efficacy in reducing congestion when used in AR, chronic rhinosinusitis. Also, comparative studies show their greater effectiveness compared to conventional isotonic solutions. Examples: Physiomer - hypertonic solution (my favorite), Aqualor-congestion, or Aqualor-severe runny nose, Aquamaris Strong.

As is known from past publications, intranasal glucocorticosteroids (iGCS) are the most effective in the treatment of AR today. They have proven efficacy in reducing nasal congestion, as well as nasal itching and watery eyes, and allow adequate control of symptoms. But, given their hormonal effect and possible harmful effects on the fetus, there are certain risks in their use. It should also be noted that at the moment there are no studies that provide reliable data confirming the danger of their use. Modern ICS — mometasone (nasonex, desrinit) and fluticasone (avamys, flixonase) has a very low systemic bioavailability, less than 1% and proven efficacy, thus can be considered as initial therapy for RB. The studies did not reveal a statistically significant relationship between the development of fetal defects and the use of these drugs. nine0003

Who are the US FDA and why is everyone listening to them?

Everything is very simple (it’s a pity that everything is not so simple with us). I copy the explanation from Wikipedia: “An agency of the US Department of Health and Human Services, one of the federal executive departments. The department is engaged in quality control of food products, medicines, cosmetics, tobacco products and some other categories of goods, and also monitors compliance with legislation and standards in this area. nine0003

Budesonide (Tafen Nasal) is classified as category B according to the FDA's classification for drug effects on the fetus, which means that there is evidence that the drug is safe to use during pregnancy. The bioavailability of budesonide is 33%. This drug has moved from group C to group B, thanks to several high-quality studies in Sweden since the beginning of the 21st century, proving its safety.

Also, according to the current recommendations of the American Academy of Allergology and Immunology (AAAAI), ICS are considered safe and effective in the treatment of rhinitis and rhinosinusitis during pregnancy. But at the same time, there is no indication of specific drugs. Other competent medical associations also do not give any recommendations in terms of choosing a drug. Therefore, summing up all of the above, and also according to the latest review, mometasone, fluticasone, budesonide can be considered as safe and effective agents in the treatment of RB. It should also be noted that an experienced ENT doctor should be involved in prescribing the drug and managing the patient, since these drugs are sold without a prescription in the Russian Federation; we strongly recommend not to self-medicate. nine0003

Yes, I will not take these hormones!

In some situations, acute respiratory viral infections during pregnancy may be accompanied (largely due to concomitant RB or AR, or their combination) with a prolonged runny nose, nasal congestion and heaviness in the face - classic symptoms of rhinosinusitis.

Learn more

• 
  How to keep child support from taking tax refund
• 
  How to make hooded towel for child
• 
  How to get sole custody of your child in illinois
• 
  Does your hair fall out when pregnant
• 
  How to get your child on a sleep schedule
• 
  February due date
• 
  How to induce labor naturally at 38 weeks
• 
  How to punish your child for lying
• 
  Can i get pregnant on my last ovulation day
• 
  Predict how your child will look
• 
  While breast feeding