OVERVIEW

What is pregnancy rhinitis?

Pregnancy rhinitis is a condition that occurs during pregnancy with nasal symptoms, such as nasal congestion lasting 6 weeks or longer, without other respiratory infection symptoms or allergic causes. These nasal symptoms completely disappear within 2 weeks after delivery. Generally, pregnancy rhinitis does not require treatment and resolves on its own, but if symptoms severely affect quality of life, symptomatic treatment may be needed to alleviate discomfort.

Is pregnancy rhinitis common?

Approximately 20% to 30% of pregnant women develop pregnancy rhinitis. Although nasal symptoms can appear at any time during pregnancy, they are more likely to occur in the middle or later stages of pregnancy.

Are pregnancy rhinitis and pregnancy drug-induced rhinitis the same condition?

No. While both pregnancy rhinitis and pregnancy drug-induced rhinitis primarily present with nasal congestion, prolonged use of nasal decongestants to relieve symptoms in pregnancy rhinitis can lead to pregnancy drug-induced rhinitis. Pregnancy rhinitis resolves on its own, whereas pregnancy drug-induced rhinitis does not and requires discontinuation of nasal decongestants.

SYMPTOMS

What are the common symptoms and manifestations of pregnancy rhinitis?

The main manifestation of pregnancy rhinitis is persistent nasal congestion (nasal mucosal congestion and edema). Other related symptoms include runny nose, sneezing, nasal itching, headache, and nosebleeds.

What adverse effects can pregnancy rhinitis cause?

Long-term nasal congestion caused by pregnancy rhinitis can lead to mouth breathing, thirst, difficulty concentrating, and even personality changes. It may also be complicated by dental caries and sinusitis, as well as snoring and obstructive sleep apnea-hypopnea syndrome (breathing pauses during sleep due to difficulty in nasal and oral airflow). Poor sleep can result in fatigue, drowsiness, headaches, and even serious complications for both the mother and fetus, such as gestational hypertension, preeclampsia, and intrauterine growth restriction.

CAUSES

What are the common causes of rhinitis during pregnancy?

The exact cause of rhinitis during pregnancy is not fully understood. In the past, it was believed to be caused by increased estrogen levels. Later studies suggest that pregnancy-related rhinitis may also be associated with progesterone, growth hormone, neuropeptides, and other factors.
Other possible causes include smoking, dust mite allergies, chronic rhinosinusitis, gestational diabetes, and obesity during pregnancy.

DIAGNOSIS

How is pregnancy rhinitis diagnosed?

When diagnosing pregnancy rhinitis, doctors primarily rely on the patient's medical history (e.g., absence of allergic diseases), symptoms (e.g., persistent nasal congestion with watery or clear mucus discharge but no other respiratory infection symptoms like coughing), physical examination, and ruling out other nasal conditions (e.g., allergic rhinitis, sinusitis).

What tests are needed to diagnose pregnancy rhinitis?

There are currently no specific tests or laboratory examinations for suspected pregnancy rhinitis. However, to differentiate it from other nasal conditions, tests such as anterior rhinoscopy, anterior rhinomanometry, subjective nasal congestion scoring, nasal endoscopy, allergen serology testing, and ultrasound may be performed.

Which diseases is pregnancy rhinitis easily confused with? How to differentiate them?

• Pregnancy rhinitis is often confused with allergic rhinitis. However, pregnancy rhinitis occurs during pregnancy and is primarily characterized by nasal congestion, whereas allergic rhinitis is triggered by allergens (e.g., dust mites, animal dander, mold, pollen) and typically exists before pregnancy, with symptoms including intense sneezing, nasal itching, and watery discharge.

• Pregnancy rhinitis may also be confused with drug-induced rhinitis, which involves a clear history of nasal decongestant medication use.

TREATMENT

Which department should I visit for pregnancy rhinitis?

Otolaryngology (ENT).

Can pregnancy rhinitis resolve on its own?

Pregnancy rhinitis usually resolves on its own, typically disappearing completely within 2 weeks after delivery. However, patients with severe symptoms may require medication to alleviate discomfort.

How is pregnancy rhinitis treated?

Since pregnancy rhinitis is self-limiting, treatment includes non-pharmacological interventions and medication:
Non-pharmacological interventions:

• Use saline nasal sprays;

• Regular physical exercise can induce physiological nasal vasoconstriction, reducing congestion;

• Elevate the head of the bed by 30–40 degrees (without compromising comfort), preferably by placing objects under the bed legs, which is more effective than using pillows;

• Nasal strips can also be tried to physically widen the nasal passages and improve congestion.

Medication:

Pregnancy rhinitis usually does not require medication and often responds poorly to drugs. Pseudoephedrine may occasionally be used for severe cases, but oral decongestants should be avoided in the first trimester and by women with hypertension. Corticosteroids, such as budesonide nasal spray, may be used—recommended once daily (128 μg per nostril in the morning) or twice daily (64 μg per nostril in the morning and evening). However, some studies suggest nasal steroids do not improve pregnancy rhinitis.

Does pregnancy rhinitis require hospitalization?

No, because symptoms are generally not severe.

What are the common side effects of medications for pregnancy rhinitis?

Nasal decongestants may be used for pregnancy rhinitis. Since these are often over-the-counter, patients can easily purchase them without a prescription. However, prolonged regular use followed by discontinuation can cause rebound congestion, leading to more frequent use. This creates a cycle of dependency, where the medication temporarily relieves congestion but worsens it afterward. Therefore, nasal decongestants should only be used for severe congestion and for no more than 3 days.

What are the benefits of saline nasal irrigation for pregnancy rhinitis?

Saline nasal irrigation improves nasal mucosal function, removes debris, secretions, and crusts, and maintains nasal patency, relieving congestion.

What precautions should be taken when performing nasal irrigation?

• Use only sterile saline solutions specifically for nasal irrigation. Avoid tap water or any unsterilized liquid, as tap water may contain bacteria, protozoa, or other microorganisms (e.g., amoebas) that could cause serious infections.

• Lean over a sink, tilt your head slightly to one side, and irrigate the higher nostril.

• When using a nasal irrigator, the solution enters one nostril and exits the other.

• Breathe through your mouth during irrigation.

• After all saline has drained, gently blow your nose, one nostril at a time.

Can pregnancy rhinitis be cured permanently?

Pregnancy rhinitis typically resolves on its own about 2 weeks after delivery.

DIET & LIFESTYLE

What should patients with pregnancy rhinitis pay attention to in terms of diet and lifestyle?

Since pregnancy rhinitis usually disappears after childbirth, existing symptoms often affect current quality of life. Therefore, some measures can be taken: In terms of diet, pay attention to nutrition during pregnancy. Eat more fresh fruits, vegetables, whole grains, low-fat dairy products, and protein (such as meat, fish, eggs, and legumes). Avoid raw, cold foods and all types of alcohol. In daily life:

• Maintain nasal hygiene. Wear a mask when going out, avoid prolonged exposure to dry and cold environments, and use a humidifier at home.

• Stay warm to prevent colds.

• Engage in moderate exercise, such as yoga, walking, or jogging, which can help relieve nasal congestion and improve sleep quality.

• Elevate the head of the bed when sleeping. Placing bricks under the bed legs is more effective than using pillows.

• Ventilate the house regularly to maintain air circulation indoors and outdoors. Avoid smoking, secondhand smoke, or polluted air.

• Wash hair and shower frequently, and change pillowcases and bedding regularly to prevent dust and mold buildup.

Does pregnancy rhinitis require follow-up visits? How are they conducted?

Patients with pregnancy rhinitis should maintain regular contact with their doctor to better manage the condition. Although treatment is usually unnecessary, if symptoms worsen and affect daily life, the doctor will provide different treatment plans based on the severity of rhinitis. The specific follow-up frequency is determined by the doctor.

PREVENTION

Can Pregnancy Rhinitis Be Prevented? How to Prevent Pregnancy Rhinitis?

Although pregnancy rhinitis cannot be completely prevented, expectant mothers can reduce the likelihood of developing it by consciously maintaining nasal health:

• Avoid crowded places whenever possible, especially during flu seasons. Wearing a mask in spring and winter can help reduce irritation from dry, cold air. Using a humidifier at home to maintain humidity around 55% and actively preventing colds can lower the chances of developing rhinitis.

• A balanced diet can help boost immunity. Eat more vegetables, fruits, and proteins, and maintain healthy eating habits.

• Moderate exercise, such as light jogging, walking, or yoga, can help relieve nasal congestion and improve sleep quality.

• Maintain nasal hygiene by ventilating rooms regularly, frequently changing pillowcases and bedding to prevent dust and mold buildup. Avoid strong irritants like secondhand smoke and mosquito coils.

• Stay in a positive mood, as emotional well-being benefits both the mother and the baby's healthy development. Avoid emotional fluctuations and negative emotions.