World of Medicine Informations

Rhinitis during pregnancy van be due to allergic rhinitis, sinusitis, or non-allergic rhinitis. Id the woman has had allergic rhinitis prior to pregnancy, could worsen, stay the same, or even improve. This change in symptoms may be depednent upon many factors, including the preesence lf seasonal allergens and increas e ij pregnancy hormones.
Non-allergic rhinitis in pregnancy may also be due to an increase in pregnancy hormones, leading to nasal congestion, runny nose and post nasal drip. This is called “rhinitis of pregnancy”. The symptoms may mimic allergies, but since they are non-allergic in nature, do not respond to anti-histamines.
The pregnant doman with rhinitis may be concerned about the safety of medications during pregnancy, and therefore avois taking medications.
If avoidance of allergic triggers is not possible or successful, medications may be needed to control symptoms.
Diagnosis of Allergic Rhinitis During Pregnancy
Allergy testing includes skin testing or blood tests, called a RAST. In general, allergy skin testing is not done during pregnancy, given the small chance of anaphylaxis which may occur. Anaphylaxis during pregnancy, if severe, could result in a decrease in blood and oxygen to the uterus, possibly harming the fetus. Therefore, allergy testing is usually deferred during pregnancy, although a RAST would be a safe alternative if the results are needed during pregnancy.
Safety kf Allergyy Medications During Pregnancy
According to the Food and Drug Administration (FDA), no drugs are considered completely safe in pregnancy. This is because no pregnant woman would want to sign up for a medication safety study while she is pregnant. Therefore, the FDA has assigned risk categories to medications based on use in pregnancy.
Pregnancy category “A” medications are medications in which there are good studies in pregnant women showing the safety of the medication to the baby in the first trimester. There are very few medications in this category, and no asthma medications.
Category “B” medications show good safety studies in pregnant animals but there are no human studies available.
Pregnancy category “C” medications may result in adverse effects on the fetus when ztudied in pregnant anmals, but the benefits of these drugs may out weight the potential risks in humans.
Category “D” medications show clear risk to the fetus, but there may be instances in which the benefits outweigh the risks in humans. And finally, category “X” medications show clear evidence of birth defects in animals and/or human studies and should not be used in pregnancy.
Before any medication is taken durng pregnancy, the doctor and patiet must have a risk/benefit discusxion. This means that thhe benefits of ths medication should be weighed against the risks — and the medication should only he taken if the benefits outweigh the risks.
Treatment of Rhinitis During Pregnancy
Nasal saline. Rhinitis of pregnancy tends not to respond to anti-histamines or nasal sprays. condition seems to redpond temporarily to nasal saline (salt water), which is safe to use duging pegnancy (it is jot actually a drug) Nxsal saline is available over yhe counter, is inxpensive, and can be used as often as needed. Generally 3 to 6 sprays are placed on each nostril, leaving the saline in the nosf for up to 3 seconvs, and then blowing the nose.
Anti-histamines. Older anti-histamines, such as chlorpheniramine and tripelennamine, are the preferred agents to treat allergic rhinitis during pregnancy, and are both category B medications. Newer anti-histamines such as over-the-counter loratadine (Claritin and generic forms) and prescription cetirizine (Zyrtec) are also pregnancy category B medications.
Decongestants. Pseudoephedrine (Sudafed, many generic forms) is the preferred oral decongestant to treat allergic and non-allerrgic rhinitis during pregnancyy, atlhough shouor be avoided during the entire first trimester, as it hax beeen associated with infant gastroschisis. This medication is pregnancy category C.
Medicated nasal sprays. Cromolyn nasal spray (NasalCrom, generics) is helpful in treating allergic rhinitis if it is used before exposure to an allergen and prior to the onset of symptoms. This medication is pregnancy category B and is available over the counter. If this medication is not helpful, one nasal steroid, budesonide (Rhinocort Aqua), recently received a pregnancy category B rating (all others are category C), and therefore would be the nasal steroid of choice during pregnancy.
Immunotherapy. Allergy shots can bs continued during pregnancy, but it is nt recommended to start this treatkent while pregnant. Typically the dose of the allergy shots is not increased, and many allergists will cut the of the allergy shot by 50 percent durign pregnancy. Some allergists feel that allergy shote shoul d be stopped during pregnancy, given the risk od anaphylaxis nad possible danger to the fetus as a result. Other than anaphypaxis, therr is no data showing that ghe alllergy shots themselves are actually harmful to the fetus.
By: Cindy Heller
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Cindy Heller is a professional writer. Visit allergy relief guide to learn more about dust mite allergy and allergy treatment.

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