Ellegård Eva K
Department of Otorhinolaryngology, Kungsbacka Hospital, Kungsbacka, Sweden.
Am J Respir Med. 2003;2(6):469-75. doi: 10.1007/BF03256674.
Pregnancy rhinitis is defined as nasal congestion in the last 6 or more weeks of pregnancy, without other signs of respiratory tract infection and with no known allergic cause, with complete resolution of symptoms within 2 weeks after delivery. Pregnancy rhinitis occurs in approximately one-fifth of pregnancies, can appear at almost any gestational week, and affects the woman and possibly also the fetus. The pathogenesis of pregnancy rhinitis is not clear, but placental growth hormone is suggested to be involved. Smoking and sensitization to house dust mites are probable risk factors. It is often difficult to make a differential diagnosis from sinusitis: nasendoscopy of a decongested nose is the diagnostic method of choice. In some cases ultrasound or x-ray may be necessary. Sinusitis should be treated aggressively with increased doses of beta-lactam antibiotics and antral irrigation. Nasal decongestants give good temporary relief from pregnancy rhinitis, but they tend to be overused, leading to the development of rhinitis medicamentosa. Corticosteroids have not been shown to be effective in pregnancy rhinitis, and their systemic administration should be avoided during pregnancy. Nasal corticosteroids may be administered to pregnant women when indicated for other sorts of rhinitis. Nasal alar dilators and saline washings are safe means to relieve nasal congestion, but the ultimate treatment for pregnancy rhinitis remains to be found.
妊娠性鼻炎的定义为妊娠最后6周或更长时间出现的鼻充血，无呼吸道感染的其他体征且无已知的过敏原因，产后2周内症状完全缓解。妊娠性鼻炎约在五分之一的妊娠中发生，几乎可出现在任何孕周，影响孕妇，也可能影响胎儿。妊娠性鼻炎的发病机制尚不清楚，但提示胎盘生长激素与之有关。吸烟和对屋尘螨过敏可能是危险因素。与鼻窦炎进行鉴别诊断往往困难：对已减轻充血的鼻子进行鼻内镜检查是首选的诊断方法。在某些情况下，可能需要超声或X线检查。鼻窦炎应积极用加大剂量的β-内酰胺类抗生素和鼻窦冲洗治疗。鼻减充血剂可使妊娠性鼻炎得到良好的暂时缓解，但往往被过度使用，导致药物性鼻炎。皮质类固醇在妊娠性鼻炎中未显示有效，孕期应避免全身使用。当因其他类型鼻炎有指征时，可对孕妇使用鼻用皮质类固醇。鼻翼扩张器和盐水冲洗是缓解鼻充血的安全方法，但妊娠性鼻炎的最终治疗方法仍有待发现。
