Sinusitis, an inflammation of the tissue lining the sinuses, is a common ailment during pregnancy. It causes discomfort when the sinus linings become inflamed and mucus drainage is inhibited.
Why Sinusitis is Common During Pregnancy
Pregnancy brings physiological changes that increase susceptibility to sinusitis. Hormonal shifts, especially elevated estrogen and progesterone, cause mucous membranes in the nose and sinuses to swell. This swelling narrows nasal passages and sinus openings, leading to congestion and infection.
Increased blood volume also contributes to nasal swelling by engorging blood vessels within the nasal passages, exacerbating stuffiness. Additionally, the immune system adjusts to tolerate the developing fetus, altering a pregnant woman’s ability to fight infections. This can increase vulnerability to viral, bacterial, or fungal infections that lead to sinusitis.
Recognizing Symptoms and Differentiating Conditions
Recognizing sinusitis symptoms is important. Common indicators include facial pain or pressure in the forehead, between the eyes, cheeks, or around the teeth and upper jaw. Nasal congestion, discolored discharge (green or yellow), and pressure-related headaches are frequent signs. A cough, often worsening at night due to post-nasal drip, can also occur.
Distinguishing sinusitis from a common cold or allergies aids self-care. If cold-like symptoms persist over ten days without improvement, or worsen after initial improvement, it may indicate a bacterial sinus infection. Unlike colds, sinusitis often features facial pain and discolored nasal discharge. Allergies, while causing nasal congestion, typically involve clear discharge and sneezing, without facial pain or fever.
Safe Management and Treatment Options
Managing sinusitis during pregnancy focuses on safe symptom relief. Home remedies are a good first defense. Saline nasal rinses or sprays effectively clear nasal passages and promote drainage. A humidifier, especially at night, keeps nasal passages moist, while steam inhalation from a hot shower or bowl of hot water loosens mucus.
Adequate rest and hydration (water, broth, decaffeinated tea) are beneficial. Warm compresses to the face or forehead can ease pain and pressure. Elevating the head with extra pillows helps mucus drain, reducing nighttime congestion and coughing.
Acetaminophen (Tylenol) is generally safe for pain and fever. Nasal steroid sprays like budesonide (Rhinocort Allergy), fluticasone (Flonase), and mometasone (Nasonex) are often safe, but triamcinolone (Nasacort) should be avoided. Short-term use (up to three days) of decongestant nasal sprays containing oxymetazoline (Afrin) or phenylephrine (Neo-Synephrine) may be an option. Antihistamines like loratadine (Claritin) and cetirizine (Zyrtec) are safe for allergy symptoms.
Avoid aspirin, ibuprofen (Advil, Motrin), and certain antibiotics like tetracyclines or fluoroquinolones due to fetal risks. Oral decongestants such as pseudoephedrine should be avoided in the first trimester. If a bacterial infection is confirmed, a healthcare provider may prescribe pregnancy-safe antibiotics like amoxicillin or cephalosporins.
When to Consult a Healthcare Provider
Consult a healthcare provider if sinusitis symptoms are severe or persistent. Seek medical attention if symptoms do not improve after 7 to 10 days of home care, or worsen significantly. Other indicators include severe facial pain or headache unresponsive to home remedies.
A high fever (above 101°F/38°C) necessitates medical evaluation, as it could signal a bacterial infection requiring prescription. Persistent green or yellow mucus, especially with worsening symptoms, suggests a possible bacterial infection. If the condition interferes with eating or sleeping, or if there are vision changes or swelling around the eyes or forehead, seek immediate medical advice. Consult an OB-GYN or general practitioner for personalized advice and to ensure medication safety.