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.
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