What is sinusitis?
Sometimes known as rhinosinusitis (inflammation of the nasal cavity and sinuses), sinusitis is inflammation or infection of one or more sinuses, which are spaces inside the bones of the skull. Sinusitis can be acute, meaning with intense symptoms that develop rapidly over hours to days, or chronic, meaning ongoing, with symptoms being mild to moderate and coming and going over a long period. Sinusitis is usually the result of infection, which can be viral (caused by a virus such as the kind of virus that causes the common cold) or bacterial (caused by infection with bacteria).
How common is sinusitis in pregnancy?
Rhinitis from the common cold, often with sinusitis symptoms, occurs in 20 – 40 percent of women of childbearing age. 10-30 percent of women with colds during pregnancy develop acute sinusitis, while others may suffer chronic sinusitis during pregnancy. Additionally, the hormonal changes of pregnancy can worsen sinusitis or trigger a non-infectious kind of sinusitis.
How is sinusitis diagnosed?
Often sinusitis is a clinical diagnosis, meaning that the diagnosis is based on your history and physical examination, during which your physician looks for symptoms such as runny or stuffed nose, red or irritated eyes, sneezing, and headache. Fever is also very common and can be the result of the cold itself or the sinusitis. The pain of sinusitis usually worsens when you lean forward, which is something that the doctor will ask you to do on the physical exam, plus the doctor may shine a light on your sinuses to see how much light shows through them. To obtain more information, blood tests and imaging, such as computed tomography (CT), may be ordered.
Does sinusitis cause problems during pregnancy?
Sinusitis can cause problems, especially if its acute bacterial sinusitis. Any type of sinusitis can give you very bad headaches, and dripping in the back of your throat (postnasal drip) can make you cough, which interferes with sleep. However, acute bacterial sinusitis causes high fever in many cases, which can make you more uncomfortable and lead to dehydration.
Does sinusitis during pregnancy cause problems for the baby?
Maternal sinusitis with high fever increases the risk of birth defects involving the heart and other organs. A study has suggested that maternal fever may possibly put the baby at risk of developing autism spectrum disorder.
What to consider about taking medications when you are pregnant:
- The risks to yourself and your baby if you do not treat the sinusitis
- The risks and benefits of each medication you use when you are pregnant
- The risks and benefits of each medication you use when you are breastfeeding
What should I know about using medication to treat sinusitis during pregnancy?
Treatment of viral sinusitis requires no more than cold medications, such as oral decongestants and fever medication. Fever medicine includes acetaminophen in the United States and paracetamol in many other countries. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen work well against both the fever and inflammation of sinusitis, as does a related group of drugs called salicylates, the most well-known one being aspirin. NSAIDs and salicylates may be harmful to the developing baby, especially late in pregnancy, but paracetamol and acetaminophen are considered safe. Other options include antihistamines for sinusitis related to allergic rhinitis and intranasal (nasal spray) steroids which are useful for chronic sinusitis.
If you develop bacterial sinusitis, you may require antibiotics, which can include penicillin, amoxicillin, azithromycin or clarithromycin. Amoxicillin, clindamycin, and several other antibiotics are thought to be safe during pregnancy.
Who should NOT stop taking medication for sinusitis in pregnancy?
If you need acetaminophen or paracetamol to combat fever during pregnancy, you should not stop taking the medication, because fever could be harmful to the baby. If your physician prescribes an antibiotic for acute bacterial sinusitis, you should not stop the treatment until it is complete, unless your doctor switches you to a different antibiotic because you do not react well to the first antibiotic that is offered to you.
What should I know about choosing a medication for sinusitis in pregnancy?
You may find Pregistrys expert reports about the individual medications to treat sinusitis here. Additional information can also be found in the sources listed at the end of this report.
What should I know about taking a medication for sinusitis when I am breastfeeding?
Some medications, including some antibiotics, may enter breast milk in large enough quantities to affect a nursing infant, while others do not. NSAIDs, acetaminophen, paracetamol, certain antibiotics, and steroids are thought to be relatively safe in mothers who breastfeed.
What alternative therapies exist besides medications to treat sinusitis during pregnancy?
You may find that using a nasal rinse of salt water from a neti pot or nasal spray helps your sinuses to heal and flushes some of the irritants out. If the salt water is warm it may also be soothing.
Surgical treatments, including removal of nasal polyps can be helpful. Usually, such surgery is delayed until after pregnancy.
What can I do for myself and my baby when I have sinusitis during pregnancy?
Follow the instructions of your physician, and be assured that this is a treatable, easily managed condition.
Resources for sinusitis during pregnancy:
For more information about sinusitis during pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or read the following articles: