Treatment of allergic rhinitis during pregnancy.
Allergic rhinitis is a frequent problem during pregnancy. In addition, physiological changes associated with pregnancy can affect the upper airways. Evidence-based guidelines on the management of allergic rhinitis have recently been published, the most recent being the Allergic Rhinitis and its Impact on Asthma (ARIA)--World Health Organization consensus. Many pregnant women experience allergic rhinitis and particular attention is required when prescribing drugs to these patients. Medication can be prescribed during pregnancy when the apparent benefit of the drug is greater than the apparent risk. Usually, there is at least one drug from each major class that can be safely utilised to control symptoms. All glucocorticosteroids are teratogenic in animals but, when the indication is clear (for diseases possibly associated, such as severe asthma exacerbation), the benefit of the drug is far greater than the risk. Inhaled glucocorticosteroids (e.g. beclomethasone or budesonide) have not been incriminated as teratogens in humans and are used by pregnant women who have asthma. A few histamine H(1)-receptor antagonists (H(1)-antihistamines) can safely be used as well. Most oral decongestants (except pseudoephedrine) are teratogenic in animals. There are no such data available for intra-nasal decongestants. Finally, pregnancy is not considered as a contraindication for the continuation of allergen specific immunotherapy.
Demoly
Pascal
P
Department of Respiratory Medicine, INSERM U454, Hospital Arnaud de Villeneuve, University Hospital of Montpellier, 34295 Cedex 5 Montpellier, France. demoly@montp.inserm.fr
Piette
Vincent
V
Daures
Jean-Pierre
JP
D000280:Administration, Inhalation; D000818:Animals; D018680:Cholinergic Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D002867:Chromones / Q000627:therapeutic use; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006801:Humans; D014663:Nasal Decongestants / Q000009:adverse effects; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy* / Q000209:etiology; D013723:Teratogens
D018680:Cholinergic Antagonists; D002867:Chromones; D005938:Glucocorticoids; D006634:Histamine H1 Antagonists; D014663:Nasal Decongestants; D013723:Teratogens