Polyps in the nose during pregnancy

Pregnancy is not only the time of happy expectation of the birth of a baby, but also the time of exacerbation of chronic diseases and the development of new ones. Quite often at this time, polyps are progressing, there is hyperplasia of the nasal mucosa. Quite often during pregnancy, multiple polyps develop which make nasal breathing difficult and cause a permanent runny nose. During pregnancy, an ideal background for the development of any neoplasms, intensive tissue growth, disease progression was created. This is due to a decrease in immunity, intensive hormonal changes, an increased level of sensitization of the body.

Progesterone is actively produced, which promotes active cell division and growth. This is useful for the fetus, as it ensures its intensive growth and development. But it can negatively affect neoplasms, the state of the mucosa, which also begin to intensively grow and develop.

After the birth of the child, the hormonal background stabilizes, so the polyps can dissolve independently without any additional intervention. If this does not happen, they can be removed, cauterized or carried out complex treatment, which is usually quite effective after delivery. Repeated excrescences are extremely rare.

[1], [2], [3], [4], [5], [6]

Causes of the polyps in the nose during pregnancy

Causes of development or exacerbation of polyps during pregnancy can also be chronic or infectious diseases, frequent colds, allergies, trauma, genetic predisposition. It is difficult to establish the exact cause, often a complex of several reasons.

[7], [8], [9], [10], [11]

Pathogenesis

Almost all polyps are initially formed in the sinuses of the nose. There is hyperplasia of the mucous membrane, as a result of which it continues to expand and gradually extends beyond the sinuses and fills the nasal cavity. The exact cause of this intensive growth has not yet been revealed.

Most experts, starting from their own practical experience, can assume that polyps are a consequence of frequent inflammatory processes, in which the mucosa does not have time to fully recover and return to a normal structural and functional state. In addition, in the sinuses of the nose, an infection often accumulates, which can directly or indirectly support the inflammatory process, causing irritation and an allergic reaction. This prevents the mucosa from completely recovering. As a result, it continues to grow and increase in size.

[12], [13], [14], [15], [16], [17], [18], [19]

Symptoms of the polyps in the nose during pregnancy

The development of the polyp takes place in three stages. In the first stage, polyps are formed in the sinus of the nose, become inflamed. During this period they practically do not bring any inconvenience to the person. In the second stage, they increase in size and begin to partially exit from the sinuses, blocking normal breathing. In the third stage, a complete exit of the polyp occurs from the sinus of the nose, as a result of which the nasal passage completely overlaps. This is the most dangerous stage, which can lead to severe obstruction of nasal breathing and nighttime apnea.

A woman experiences first of all, a strong nasal congestion. There may appear a runny nose, chronic inflammation and swelling. The mucous membrane significantly increases in size, the nasal septum is curved. Violated first local immunity, over time, a systemic impairment of immunity may develop.

It is difficult for a woman to breathe, at the third stage she is practically unable to breathe through her nose. 

Stages

There are three stages of development of polyps. At the first stage, the mucosa is overgrown, the polyp is sufficiently localized, of a small size. In the second stage, it partially blocks the nasal cavity, making breathing difficult. The most dangerous is the third stage, which completely closes the nasal passage, nasal breathing completely stops. At this stage, the only way to solve the problem is to surgically remove the polyp.

In polyps of the 1st stage, only the mother usually feels discomfort. Nasal breathing is difficult, but it can still be fully compensated by breathing with the mouth. In the second and third stages, problems and discomfort are already experiencing a fetus. Overlapping the nasal course of polyp significantly reduces the flow of oxygen to the tissues, respectively, not only the flow of oxygen, but also the removal of carbon dioxide. In this case, it is necessary to take measures, since a prolonged disruption of oxygen supply can lead to a delay in intrauterine development, fetal hypoxia, premature birth.

[20], [21], [22], [23], [24], [25]

Complications and consequences

Among the most difficult consequences include impaired olfactory function, nasal voice, constant snoring. Gradually, there is a lack of oxygen, hypoxia develops, which leads to a violation of metabolic processes, a lack of oxygen in the internal organs and tissues. At the same time, the amount of carbon dioxide in the blood increases, the headache, migraine develops.

[26], [27], [28], [29]

Diagnostics of the polyps in the nose during pregnancy

In order to conduct the correct treatment, you must first correctly diagnose and determine the cause of the pathology. Quite informative is the method of endoscopy of the nasal cavity and nasal sinuses. In many modern clinics the method of video endoscopy is applied. They make it possible to determine the severity of the pathology and the extent of the pathological process.

Often resorted to the method of computer or magnetic resonance therapy, which allows you to visualize the state of the nasal cavity and paranasal sinuses. In addition, these methods can provide information on the status of bones, nasal septum and surrounding soft tissues.

To detect polyps, most often used methods such as examination of nasal passages, computed tomography of the paranasal sinuses. You may also need to consult a dentist and an allergist. Based on the diagnostic results, the optimal treatment regimen is selected. The doctor selects therapy taking into account the degree and severity of pathological education, its cause, the duration of pregnancy, the features of the course, the general condition of the mother and the fetus.

[30], [31], [32], [33], [34]

Treatment of the polyps in the nose during pregnancy

The treatment is based on restoring normal nasal breathing, as well as reducing the size of polyps, or completely removing them. Both conservative and radical treatments are used. More effective are surgical methods of research, which make it possible to completely remove the polyp. In addition, methods aimed at preventing recurrences of the disease are required. It is recommended to remove by endoscopic or laser method. After surgery, conservative therapy is used to restore the mucous membrane.

First try to apply conservative methods, and only with their inefficiency resort to surgical methods. The basis of conservative treatment are antibacterial and antiallergic agents, topical steroids. Prescribe medications with caution, having previously tested the effectiveness and safety. For example, before prescribing antibiotics, it is advisable to carry out a bacteriological study isolating the pathogen and selecting a sensitive antibiotic and its optimal concentration. It is advisable to prescribe steroids only after 14 weeks.

Conservative methods are resorted to ineffectiveness of conservative therapy, complete overlapping of nasal passages and risk of fetal hypoxia, severe snoring, loss of smell, dizziness and frequent headaches. Also the indication is hearing impairment, abundant discharge from the nose, especially bloody nature, rapid growth of polyps and suspicion of their malignant nature.

Basically, the operation is performed after childbirth. Indication for the operation during pregnancy is the complete closure of the nasal passages. It is better to carry out the operation in the period of 24-30 weeks, because during this period the risks are minimized. There are all chances for successful removal of polyps, rapid recovery. The risks for the child are also minimal: this will not affect the further development of the fetus. The operation is performed only if the woman is well. After the polyps are removed, measures must be taken to prevent their proliferation.