Treatment of allergic rhinitis during pregnancy

Allergic rhinitis (AR) affecting approximately 20-30% of women in childbearing age can be considered one of the most common group of medical conditions that complicate pregnancy. AR with symptoms of nasal obstruction, sneezing, and itching may require pharmacotherapy. However, there are concerns reg...

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Bibliographic Details
Published in:American journal of rhinology 2004-01, Vol.18 (1), p.23-28
Main Author: KeleSl, Nesil
Format: Article
Language:English
Subjects:
Administration, Oral
Administration, Topical
Adult
Allergens
Anti-Asthmatic Agents - administration & dosage
Anti-Asthmatic Agents - adverse effects
Anti-Asthmatic Agents - therapeutic use
Cromolyn Sodium - administration & dosage
Cromolyn Sodium - adverse effects
Cromolyn Sodium - therapeutic use
Female
Health Behavior
Histamine H1 Antagonists - administration & dosage
Histamine H1 Antagonists - adverse effects
Histamine H1 Antagonists - therapeutic use
Humans
Immunotherapy
Nasal Decongestants - administration & dosage
Nasal Decongestants - adverse effects
Nasal Decongestants - therapeutic use
Pregnancy
Pregnancy Complications - drug therapy
Rhinitis, Allergic, Perennial - drug therapy
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Summary:Allergic rhinitis (AR) affecting approximately 20-30% of women in childbearing age can be considered one of the most common group of medical conditions that complicate pregnancy. AR with symptoms of nasal obstruction, sneezing, and itching may require pharmacotherapy. However, there are concerns regarding the safety of different available agents that can be used during pregnancy with respect to both maternal and fetal well being. The best first-line approach in the management of AR is avoidance of allergens. If environmental modification is ineffective, then the pharmacologic agents should be chosen. For symptoms of rhinorrhea, sneezing, or itching, intranasal cromolyn, with its excellent safety profile, should be considered as first-line therapy. If cromolyn is ineffective or poorly tolerated, first-generation (e.g., chlorpheniramine and tripelennamine) and second generation (e.g., cetirizine and loratadine) antihistamines can be given. Intranasal steroids (e.g., beclomethasone dipropionate, and budesonide) can be added to first-line therapy especially for severe nasal obstruction. There are no epidemiological studies with newer intranasal steroids (e.g., flunisolide, triamcinolone acetonide, fluticasone propionate, and mometasone furoate) during the first trimester of pregnancy. Immunotherapy has not proven to be teratogenic and is clinically useful in improving symptoms. Oral and topical decongestants can be considered as second-line therapy, for short-term relief, when no safer alternative is available.
ISSN:1050-6586
1945-8924
1539-6290
1945-8932
DOI:10.1177/194589240401800106