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Thursday, March 26, 2015

Runny Noses in Pregnancy, Possibly Not Just an Upper Respiratory Infection

When you are pregnant every part of your body is dramatically effected by the physical changes that accommodate the developing baby. The uterus grows from 70 grams to 1000 grams, most women gain  at least a couple of stone, and your skin starts taking on pigments that may fade but never leave! We notice a our tastes changing, and our smell changing, and generally we ignore what seems minor. But what may seem minor, but often isn't in pregnancy, is the runny nose and altered hearing women report. The changes in the ear, nose and throat are primarily due to changes in the circulatory system, such as the extra fluid in our circulation and the extra fluid our heart pumps. We also have some presumed increased susceptibility to viral infections, as well as some pressure changes from the bulk pressure of the growing uterus. All of these can oddly lead to increased runny nose! This can range from the very minor changes such as an occasional sneeze or drips, or become ringing in the ears or tinnitus, facial palsies, and even cases of deafness. Since it is the pregnancy that caused it, it should be self limiting to pregnancy as well. As the levels of estrogen and progesterone rise without enough corresponding change in cortisol levels or immune enhancement there may also be heightened sensitivity to allergens may influence the engorgement of the nasal mucosa. More fragile nasal passage linings can in term cause epistaxis (bloody nose) and rhinitis. Most treatment regimens of these complaints do not differ from the treatment of these conditions in the non-pregnant state other than being aware of the effects of any selected medication on the fetus, as most advice relies on case reports or reports of case series. What did you notice during your pregnancy? Were there any treatments that helped you especially? Let me know!

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