Upper airway congestive symptoms during pregnancy have been recognized since the turn of the century.<sup>60 MacKinzie J.N. The physiological and pathological relations between the nose and the sexual appearance of man Alienst Neurol 1898 ;  19 : 219-239

Haga clic aquí para ir a la sección de Referencias</sup> Among randomly selected pregnancies, as many as 30% of patients report substantial symptoms of rhinitis and rhinosinusitis, and this figure may be higher among patients with pre-existing atopic disease.<sup>21 Ellegard E., Karlsson G. Nasal congestion during pregnancy Clin Otolaryngol 1999 ;  24 : 307-311  [cross-ref]

Haga clic aquí para ir a la sección de Referencias, 58 Mabry R.L. Rhinitis of pregnancy South Med J 1986 ;  79 : 965-971  [cross-ref]

Haga clic aquí para ir a la sección de Referencias, 59 Mabry R.L. Intranasal steroid injection during pregnancy South Med J 1980 ;  73 : 1176-1179  [cross-ref]

Haga clic aquí para ir a la sección de Referencias</sup> “Rhinitis of pregnancy” can take many forms. The incidence of allergic rhinitis among women of childbearing years is approximately 20%.<sup>82 Schatz M., Hoffman C.P., Zeiger R.S. , y al. The cause and management of asthma and allergic diseases during pregnancy Allergy: Principles and Practice St. Louis: CV Mosby (1988).  1093-1155

Haga clic aquí para ir a la sección de Referencias</sup> Of those pregnant women with known allergies, some studies suggest that approximately 10% will experience increasing allergic symptoms during their pregnancy and 90% will remain the same.<sup>35 Hamano N., Terada N., Maesako K. , y al. Effect of sex hormones on eosinophilic inflammation in nasal mucosa Allergy and Asthma Proc 1998 ;  19 : 263-269  [cross-ref]

Haga clic aquí para ir a la sección de Referencias, 94 Terada N., Konno A. Allergic diseases—especially on the relation of pregnancy Obstet Gynecol 1992 ;  59 : 31-36

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Other rhinitis presentations in pregnancy include rhinosinusitis, rhinitis medicamentosa, and the ill-defined vasomotor rhinitis. Further complicating the picture is the fact that the frequency of sinusitis may be as high as 1.5% in pregnancy, which represents a sixfold increase over the frequency observed in a nonpregnant population.<sup>91 Sorri M., Bortikanen-Sorri A.L., Karja J. Rhinitis during pregnancy Rhinology 1980 ;  18 : 83-86

Haga clic aquí para ir a la sección de Referencias</sup> Pregnant women also tend to develop rhinitis medicamentosa, complicating other rhinitis syndromes, probably because of their tendency to use exclusively topical medications to protect their fetuses.<sup>50 Lekas M.D. Rhinitis during pregnancy and rhinitis medicamentosa Otolaryngol Head Neck Surgery 1992 ;  107 : 845-848

Haga clic aquí para ir a la sección de Referencias</sup> A more nonspecific form of rhinitis is described by some pregnant women as nasal stuffiness with some dryness and episodes of epistaxis. This form has been given the confusing term vasomotor rhinitis, which implies an alteration of the natural integrity of the vasomotor or secretomotor function of the nose; however, nasal vascular pooling secondary to the increased circulating blood volume and perhaps other nasal reactive enhancement properties induced by maternal hormones have been forwarded as more likely mechanisms.

There is understandable reluctance on the part of physicians caring for pregnant patients to employ the modalities commonly used in the diagnosis and management of rhinitis because of fetal risk factors, the time-limited nature of pregnancy, and the litigious nature of the American public. There are few data regarding the clinical effect of the various forms of rhinitis on pregnancy. On the surface it seems unlikely that gestational forms of rhinitis would have a deleterious effect on the course of pregnancy; however, uncontrolled atopic rhinitis or sinusitis during pregnancy may aggravate coexisting asthma, which can have a distinct adverse effect on pregnancy outcome. Furthermore, the risk of sinusitis and the impact rhinitis may have on the pregnant mother's eating, sleeping, and emotional well-being could be significant, suggesting that rhinitis during pregnancy should be actively evaluated and treated to optimize pregnancy outcome.