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Nasal congestion is a common yet frequently underappreciated symptom during pregnancy. While often attributed to coincidental viral infections or allergies, a distinct entity known as "rhinitis of pregnancy" (ROP) exists, characterized by nasal obstruction in the absence of other infectious or allergic triggers. This paper reviews the epidemiological evidence, explores the multifactorial pathophysiology driven by hormonal fluctuations (estrogen, progesterone, and placental growth hormone) and increased plasma volume, discusses the clinical presentation and differential diagnosis, and provides evidence-based guidelines for safe management during gestation and lactation.
Most INCS, saline, and intranasal antihistamines are compatible with breastfeeding (Lactation Risk Category L1-L2). Pseudoephedrine can reduce milk supply and should be avoided. Oxymetazoline is considered compatible for short-term use. pregnancy and congestion
The Physiology and Management of Nasal Congestion in Pregnancy: A Review of "Rhinitis of Pregnancy" Nasal congestion is a common yet frequently underappreciated
Management of ROP emphasizes safety for both mother and fetus. The FDA pregnancy risk categories (A, B, C, D, X) provide guidance, though many drugs lack rigorous pregnancy trials. The Physiology and Management of Nasal Congestion in
Pregnancy induces profound physiological adaptations across nearly every organ system. Among the most common otorhinolaryngological changes is nasal congestion, affecting an estimated 20% to 40% of pregnant individuals, with prevalence peaking in the second trimester. Despite its frequency, pregnancy-related congestion is often trivialized as a minor inconvenience. However, severe cases can significantly impair quality of life, disrupt sleep, contribute to snoring and obstructive sleep apnea (OSA), and affect maternal blood pressure regulation. Understanding the distinction between benign ROP and other causes of congestion is critical for appropriate management.