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Management

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

  • when managing women with pregnancy rhinitis, the selflimited nature of the condition underscores the critical aspects of management: safety to the fetus and short-term symptomatic relief for the mother
  • environmental modification can optimize intranasal functioning
    • simple measures such as elevation of the head of the bed, adequate fluid intake, proper room humidity, and avoidance of cigarette smoke and other environmental irritants are essential
  • intranasal saline instillation is a low risk and often effective intervention, as are OTC nasal strips
    • nasal strips can enhance nasal patency, particularly in the nasal valve area - a structurally narrow part of the anterior nose that often cannot withstand even minor nasal oedema without the resulting subjective experience of nasal obstruction.
    • nasal saline and the nasal strips are excellent first line interventions for women who are reluctant to take medications during pregnancy
  • exercise
    • mild to moderate exercise is another valuable first line intervention, provided the pregnant woman has no other contraindications precluding exercise
    • likely mechanism of relief following exercise is the role of moderate exercise as a vasoconstrictor
      • typical exercise sessions are associated with nasal vasoconstriction for roughly one hour following the session
  • medication
    • nasal decongestants should be avoided for prolonged periods of time, as their use induces rhinitis medicamentosa
    • if the patient has difficulty discontinuing use of nasal decongestants, nasal corticosteroids could be effective, but they have not been shown to be effective in isolated pregnancy rhinitis
    • systemic corticosteroids and oral decongestants should not be used

Notes:

  • as well as rhinitis medicamentosa, sinusitis is a differential diagnosis, which needs to be borne in mind.

Reference:

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