Background: Nasal rinsing appears particularly suitable in the management of pregnant women with seasonal allergic rhinitis since no deleterious effects on the fetus are to be expected. However, to date, no studies have specifically investigated this option. Methods: Pregnant women with seasonal allergic rhinitis were randomized to intranasal lavage with hypertonic saline solution 3 times daily (n = 22) versus no local therapy (n = 23) during a 6-week period corresponding to the pollen season. Patients were invited to keep a daily record of rhinitis symptoms (rhinorrea, obstruction, nasal itching and sneezing), to record consumption of oral antihistamine and to undergo rhinomanometry. Results: The rhinitis score was similar at study entry but a statistically significant improvement in this score was observed in the study group during all subsequent weeks (p < 0.001 for weeks 2–6). The mean number of daily antihistamines use per patient per week was significantly reduced at weeks 2, 3 and 6 (p < 0.001, p < 0.001 and p = 0.001, respectively). Baseline rhinomanometry performed at week 1 showed similar nasal resistance in the study and control groups. In contrast, a statistically significant difference emerged in the 2 following evaluations. At week 3, nasal resistance in the study and control groups was 0.96 ± 0.44 and 1.38 ± 0.52 Pa/ml/s, respectively (p = 0.006). At week 6, it was 0.94 ± 0.38 and 1.35 ± 0.60 Pa/ml/s, respectively (p = 0.006). No adverse effect was reported in the active group. Conclusions: Nasal rinsing is a safe and effective treatment option in pregnant women with seasonal allergic rhinitis.

1.
Ellegard EK: The etiology and management of pregnancy rhinitis. Am J Respir Med 2003;2:469–475.
2.
Incaudo GA: Diagnosis and treatment of allergic rhinitis and sinusitis during pregnancy and lactation. Clin Rev Allergy Immunol 2004;27:159–177.
3.
Ellegard EK: Clinical and pathogenetic characteristics of pregnancy rhinitis. Clin Rev Allergy Immunol 2004;26:149–159.
4.
Blaiss MS, Food and Drug Administration (U.S.); ACAAI-ACOG (American College of Allergy, Asthma, and Immunology and American College of Obstetricians and Gynecologists): Management of rhinitis and asthma in pregnancy. Ann Allergy Asthma Immunol 2003;90:16–22.
5.
Palmer GW, Claman HN: Pregnancy and immunology: selected aspects. Ann Allergy Asthma Immunol 2002;89:350–359.
6.
Demoly P, Piette V, Daures JP: Treatment of allergic rhinitis during pregnancy. Drugs 2003;63:1813–1820.
7.
Salib RJ, Howarth PH: Safety and tolerability profiles of intranasal antihistamines and intranasal corticosteroids in the treatment of allergic rhinitis. Drug Saf 2003;26:863–893.
8.
Mazzotta P, Loebstein R, Koren G: Treating allergic rhinitis in pregnancy. Safety considerations. Drug Saf 1999;20:361–375.
9.
Gilbert C, Mazzotta P, Loebstein R, Koren G: Fetal safety of drugs used in the treatment of allergic rhinitis: a critical review. Drug Saf 2005;28:707–719.
10.
Ciprandi G, Liccardi G, D’Amato G, Motolese A, Giannetti A, Fasce R, Venturini P, Negrini AC, De Stefano F, Celesti R, Canonica GW: Treatment of allergic diseases during pregnancy. J Investig Allergol Clin Immunol 1997;7:557–565.
11.
Keles N: Treatment of allergic rhinitis during pregnancy. Am J Rhinol 2004;18:23–28.
12.
Demoly P, Piette V, Daures JP: Treatment of allergic rhinitis during pregnancy. Drugs 2003;63:1813–1820.
13.
Ferguson BJ: Allergic rhinitis: options for pharmacotherapy and immunotherapy. Postgrad Med 1997;101:117–126.
14.
Taccariello M, Parikh A, Darby Y, Scadding G: Nasal douching as a valuable adjunct in the management of chronic rhinosinusitis. Rhinology 1999;37:29–32.
15.
Tomooka LT, Murphy C, Davidson TM: Clinical study and literature review of nasal irrigation. Laryngoscope 2000;110:1189–1193.
16.
Garavello W, Romagnoli M, Sordo L, Gaini RM, Di Berardino C, Angrisano A: Hypersaline nasal irrigation in children with symptomatic seasonal allergic rhinitis: a randomized study. Pediatr Allergy Immunol 2003;14:140–143.
17.
Garavello W, Di Berardino F, Romagnoli M, Sambataro G, Gaini RM: Nasal rinsing with hypertonic solution: an adjunctive treatment for pediatric seasonal allergic rhinoconjunctivitis. Int Arch Allergy Immunol 2005;137:310–314.
18.
Delafuente JC, Davis TA, Davis JA: Pharmacotherapy of allergic rhinitis. Clin Pharm 1989;8:474–485.
19.
Kern EB: Committee report on standardization of rhinomanometry. Rhinology 1981;19:231–236.
20.
Ozsoylu S: Nose drops and the common cold. Eur J Pediatr 1985;144:294–297.
21.
Karadag A: Nasal saline for acute sinusitis. Pediatrics 2002;109:165.
22.
Kurtaran H, Karadag A, Catal F, Avci Z: A reappraisal of nasal saline solution use in chronic sinusitis. Chest 2003;124:2036–2037.
23.
Georgitis JW: Nasal hyperthermia and simple irrigation for perennial rhinitis. Changes in inflammatory mediators. Chest 1994;106:1487–1492.
24.
Ponikau JU, Sherris DA, Kephart GM, Kern EB, Congdon DJ, Adolphson CR, Springett MJ, Gleich GJ, Kita H: Striking deposition of toxic eosinophil major basic protein in mucus: implications for chronic rhinosinusitis. J Allergy Clin Immunol 2005;116:362–369.
25.
Talbot AR, Herr TM, Parsons DS: Mucociliary clearance and buffered hypertonic saline solution. Laryngoscope 1997;107:500–503.
26.
Boek WM, Graamans K, Natzijl H, van Rijk PP, Huizing EH: Nasal mucociliary transport: new evidence for a key role of ciliary beat frequency. Laryngoscope 2002;112:570–573.
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