Nasal Lavage in Pregnant Women with Seasonal Allergic Rhinitis: A Randomized Study

Abstract

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.

Efficacy of buffered hypertonic saline nasal irrigation in children with symptomatic allergic rhinitis: A randomized double-blind study

“…The efficacy of BHS is also supported by the significant decrease of the use of antihistamine in 2nd visit. It is in line with Garavello et al [19,27]. Furthermore, we found that the BHS group had better compliance with irrigations than the NSS group.…”

“…The results are in line with previous studies. Garavello et al [19] found that BHS nasal irrigation in AR significantly decreased mean daily score, Subsequently, they reported that hypertonic saline nasal irrigation in pregnant woman with seasonal AR significant improved rhinitis score [27]. However, NSS irrigation was not included in both study.…”

“…7-Point Likert scale [27] for satisfaction to use nasal irrigation [25] At trial entry and at 2nd and 4th weeks follow-up, patients were asked to score the child's health status on a 7-point Likert scale. Responses were recorded on a scale from 1 (indicating unsatisfactory) to 7 (indicating excellent).…”

Overview of the Treatment of Allergic Rhinitis and Nonallergic Rhinopathy

“…In this population, hypertonic irrigation three times daily led to reduced self-reported nasal symptoms, medication use, and objective measurements of nasal patency (115). In addition, rinsers had a markedly reduced need for oral AHs during 5 of the 7 weeks (114).…”

Nasal Irrigation: An Imprecisely Defined Medical Procedure

“…To overcome these problems at least partially, NI has been considered and several studies were planned to evaluate its real efficacy. A systematic review and meta-analysis of the studies published until 2010 [73] selected 10 trials [37,74,75,76,77,78,79,80,81,82], 7 of which were randomized and controlled studies. Three studies included children.…”