Update Schwangerschaftsrhinitis

Die sog. Schwangerschaftsrhinitis (SSR) zählt zu den endokrinen nasalen Hyperreaktivitäten. Etwa ein Viertel aller Schwangeren ist von diesem Krankheitsbild betroffen, das zu jedem Zeitpunkt der Schwangerschaft auftreten kann. Pathophysiologisch werden vor allem hormonelle Einflüsse diskutiert, Rauchen sowie eine vorbestehende Hausstaubmilbenallergie gelten als Risikofaktoren. Therapeutisch empfiehlt sich ein Stufenschema.

Kernaussagen

• Die SSR als ein häufiges Krankheitsbild; etwa ein Viertel der Schwangeren ist davon betroffen – mit z. T. erheblicher Beeinträchtigung der Lebensqualität.

• Sie wird zumeist pharmakotherapeutisch behandelt.

• Bei leichtem Beschwerdebild genügt die lokale Befeuchtung (0,9% NaCl-Lösung) sowie die Pflege der nasalen Mukosa mit Dexpanthenol-haltigen Nasensalben.

• Bei starker Einschränkung der Nasenatmung eignen sich kurzfristig topische α-Mimetika in Form von Nasentropfen bei strenger Indikationsstellung.

• Besteht eine zusätzliche allergische Rhinitis eignet sich die topische Applikation resorbierbarer Glukokortikoide ohne große systemische Wirkung.

• Die topische Applikation von Glukokortikoiden auch ohne Vorliegen einer allergischen Rhinitis einer längerfristigen Einnahme von α-Symptomimetika vorzuziehen.

• Antihistaminika und operative Verfahren sollten nur in Ausnahmefällen in Betracht gezogen werden.

Schlüsselwörter

Schwangerschaft - Rhinitis - Rhinopathia gravidarum - nasale Hyperreaktivität

• Literatur

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