Gaymoritis during pregnancy

Sinusitis during pregnancy is a disease that many expectant mothers face. Let's consider the main causes of the disease, diagnostic methods, as well as methods of treatment and prevention.

Sinusitis is a category of sinusitis and is an inflammation of the mucous membrane of the maxillary sinuses. The maxillary sinuses are large air-filled cavities inside the maxillary bones. They communicate with the nasal sinus through the mouths. As a rule, the inflammation develops simultaneously with or after damage to the mucous membrane, and can be bilateral or unilateral.

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Causes maxillary sinusitis in pregnancy

Most often, inflammation of the nasal sinuses occurs due to viral and bacterial infections. Harmful microorganisms enter the maxillary sinuses from the oral cavity in the presence of dental diseases, from the nasal cavity in the case of rhinitis, as well as in case of damage to the tonsils, that is, adenoiditis and tonsillitis. The development of the disease is facilitated by polyps in the nose, congenital anomalies of the facial skull, curvature of the nasal septum.

The causes of sinusitis during pregnancy are associated with a weakened immune system. This creates the prerequisites for inflammatory processes. Getting on the mucous membrane of the sinuses and nose, infectious microorganisms cause its swelling and increased mucus production. Since the outflow of sinus contents is impaired, all conditions are created for the reproduction of bacteria and the development of purulent inflammation.

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Pathogenesis

The disease can become acute if it occurs simultaneously with other inflammatory lesions of the body. It appears due to the influence of infectious diseases of the upper respiratory tract, pathologies in the nasopharynx and oral cavity. If the symptoms of the disease are left without medical attention, then after a couple of weeks the pathology becomes chronic, the treatment of which is quite complex and long. Sinusitis is characterized by purulent accumulations and discharge, very often it is called rhinosinusitis.

The mechanism of development of inflammatory lesions of the nasal sinuses is associated with the influence of infectious microorganisms and bacteria. Pathogenesis is based on the effect of streptococci, staphylococci, viral agents, fungi, hemophilic bacilli, chlamydia on the mucous membrane of the nose. Sinusitis can develop due to severe acute respiratory diseases or infectious microbes in the respiratory tract.

In some cases, the disease develops due to neglected dental diseases. Congenital curvature of the nasal septum or long-term allergic diseases also provoke inflammation.

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Symptoms maxillary sinusitis in pregnancy

The body of the expectant mother does not have high protective properties, so even the slightest infection can cause a serious inflammatory process. Symptoms of sinusitis during pregnancy depend on the cause of its development. The disease can be suspected in the case of a long course of respiratory infections and the absence of the necessary treatment.

• Inflammation of the maxillary sinuses causes a deterioration in the general condition. Headaches, rapid fatigue, weakness appear, appetite worsens due to nasal congestion, and the sense of smell decreases.
• When the nasal cavities are filled with pus or mucus, the pressure in them increases. This manifests itself as bursting pain under the eyes in the cheek area, slight swelling of the lower eyelids and cheeks on the affected side.
• The discomfort increases when the head is tilted forward. If the patency of the nostrils is preserved, then a discharge of yellow-green thick mucus is observed.
• When tapping under the eyes, that is, in the area of the maxillary sinuses, painful sensations arise.

At later stages, sinusitis is accompanied by the release of mucus and pus, severe cough, fever and chills. Conjunctivitis and pain with sudden head movements may develop. These signs indicate a chronic, i.e. advanced form of the pathology.

First signs

Any illness during pregnancy has a complex course, which threatens serious consequences for the mother and fetus. The first signs of sinusitis are as follows:

• Difficulty breathing, heavy breathing.
• Headaches.
• Temperature increase.
• Painful sensation in the nose.
• Stuffy nose.
• The sinuses are filled with mucus and thick purulent discharge.

The disease is accompanied by unpleasant sensations of the entire face. Sometimes it seems that the face is a solid hematoma. Any movement of the head, turns, and bends cause piercing sharp pains. If such symptoms appear, you must immediately seek medical help.

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Is sinusitis dangerous during pregnancy?

At the first symptoms of acute respiratory infections and other inflammatory diseases that occur during pregnancy, it is necessary to seek medical help. Many expectant mothers have a question: is sinusitis dangerous during pregnancy? Yes, it is. Since the disease is characterized by nasal congestion, there is a deficiency of oxygen entering the body. This leads to disruption of the normal functioning of organs and systems. For the expectant mother, this is fraught with disruptions in the functioning of the cardiovascular system and lungs. The disease can lead to fetal hypoxia and developmental disorders.

As sinusitis progresses, serious complications arise, which can only be eliminated surgically. At the same time, there is a high risk of harm to the unborn child, since operations during pregnancy are dangerous. The absence of necessary treatment can lead to kidney damage, myocarditis, brain abscess and meningitis.

Forms

According to the International Classification of Diseases, 10th revision, sinusitis belongs to several categories at once.

Class X Diseases of the respiratory system (J00-J99)

J00-J06 Acute respiratory infections of the upper respiratory tract

• Acute sinusitis is included in the category (J00- J06) Acute respiratory infections of the upper respiratory tract. Code J01.0 Acute maxillary sinusitis (sinusitis).
• Chronic sinusitis is classified under the heading (J30- J39) Other diseases of the upper respiratory tract. Code J32.0 Chronic maxillary sinusitis.

Very often there is a need to clarify the origin of the pathogen that caused the disease. For this, additional coding B95-B97 is used. According to the classification, B95 - streptococci and staphylococci, as the cause of diseases located in other headings. B96 - other bacterial agents. B97 - viruses that provoked the onset of inflammation.

Purulent sinusitis during pregnancy

The most dangerous and difficult to cure disease is purulent sinusitis. During pregnancy, this pathology develops due to the lack of proper treatment and blurred symptoms. Very often, when this form of inflammation appears, doctors fear the spread of infection to nearby organs and tissues.

Symptoms of the disease manifest as profuse nasal discharge, loss of smell, painful sensations in the temples and bridge of the nose, heaviness in the head, difficulty breathing through the nose. A pregnant woman should be alerted by a night cough, a bursting pressure on the roots of the teeth. If the purulent process is neglected, then a decrease in performance and a sharp increase in temperature are observed.

Purulent sinusitis during pregnancy develops under the following conditions:

• The presence of pathogenic microflora in the respiratory tract.
• Weakening of the protective properties of the mucous membranes of the nasal cavity.
• Anatomical features of the structure of the nasal septum.

For diagnosis, it is necessary to undergo an examination by an otolaryngologist. The doctor collects anamnesis, conducts an X-ray examination of the nasal sinuses. On the X-ray, the disease looks like a darkening. Diagnostic puncture may be used. This method is used if pathological changes in the sinuses are detected on the X-ray. Puncture of the sinus allows you to pump out accumulated pus and reduce pressure. If the pregnant woman refuses this procedure, it can lead to conjunctivitis or encephalitis.

Treatment should be comprehensive. Antibiotics, physiotherapy and general strengthening methods are used to eliminate the disease. But the use of antibiotics and any other medications during pregnancy is very dangerous, as it can lead to serious complications. Therefore, safer herbal remedies are recommended to eliminate inflammation, which the doctor selects individually for each patient.

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Complications and consequences

Without timely diagnosis and treatment, sinusitis during pregnancy causes many adverse effects. The outcome of the disease is significantly complicated by the fact that the inflamed sinuses are close to such vital organs as the eyes, brain and throat.

Common consequences of rhinosinusitis:

• Inflammation of the auricles.
• Inflammation of the optic nerves.
• Pharyngitis, tonsillitis.
• Osteomyelitis.
• Conjunctivitis.
• Trigeminal neuritis.
• Pneumonia, bronchitis, pneumonia.
• Purulent abscess in the nose.
• Meningitis.

The above-described diseases are dangerous for the health of the expectant mother and her unborn child. To eliminate them, it is necessary to use potent drugs that are contraindicated during pregnancy. Another unfavorable complication is the transition of the disease to a chronic form. Do not forget that the infection can get into the blood and harm the baby. In addition, inflammation provokes oxygen starvation of the fetus, which also negatively affects its development.

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Consequences of sinusitis during pregnancy for the child

Damage to the nasal sinuses causes constant nasal congestion, which leads to oxygen deficiency. The consequences of sinusitis during pregnancy for the child depend on how the pathological process proceeds in the mother and what treatment was used to eliminate it. The absence of normal breathing in a woman provokes the following pathologies in the fetus:

• Hypoxia.
• Blood pressure disorders.
• Problems with the cardiovascular system and central nervous system.
• Swelling of the eye tissue.
• Periostitis.
• Encephalitis.
• Rheumatoid arthritis.
• Rhinogenous abscess.

Timely initiation of treatment and adherence to medical recommendations can help avoid the above-described pathologies.

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Complications

Sinusitis is a serious health threat. Complications develop due to poor treatment or lack thereof. Inflammation provokes swelling of the mucous membrane of the inner lining of the nose and maxillary sinuses. Pregnant women have difficulty breathing through their nose, which causes a huge number of pathogenic microorganisms to accumulate in the nose. The gradual increase in harmful bacteria aggravates the pathology.

All complications are conventionally divided into two groups:

• Acute sinusitis becomes chronic and is accompanied by painful symptoms. Cardiovascular and respiratory system pathologies, shortness of breath, hypoxia, headaches.
• The inflammatory process affects the pharynx and tonsils, causing the development of adenoids and tonsillitis. Hypertrophy of the nasal mucosa and the formation of polyps - tumor-like neoplasms - are observed.

Let's consider complications of the disease that manifest themselves in other organs and systems:

• Visual system - edema of the cellular tissue, thrombosis of veins, purulent-inflammatory processes in the soft tissues of the orbit. In addition, swelling and redness of the eyelids, visual impairment and limited eye mobility, pain when pressing on the orbit are observed.
• Osteoperiostitis is an inflammatory lesion of bones that occurs due to the transition of the pathological process from the mucous membranes to bone tissue. The pathology can be simple and purulent, but in both cases it is a complication of sinusitis.
• Meningitis - most often occurs due to self-treatment of the disease and the transition of inflammation into a chronic form. There are many types of meningitis, but all of them are accompanied by severe headaches, fear of light and loud sounds, fever.
• Sepsis is the most dangerous complication. Blood poisoning occurs due to the penetration of putrefactive bacteria and their toxins into it. For treatment, it is necessary to eliminate the primary source of inflammation. But without proper therapy, sepsis leads to death.

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Diagnostics maxillary sinusitis in pregnancy

During pregnancy, the expectant mother should pay special attention to her health. At the first signs of an inflammatory or any other pathological process, it is necessary to consult a doctor. Diagnosis of sinusitis during pregnancy is carried out at the first signs of the disease.

Let's look at the main diagnostic procedures that an otolaryngologist prescribes:

• Taking anamnesis – the doctor asks about complaints of nasal congestion, severe pain in the maxillary sinuses, cough, headaches and other signs of illness.
• Visual examination – with its help it is possible to detect redness and swelling of the infraorbital region due to reflex vasodilation.
• Rhinoscopy - there is inflammation and swelling on the surface of the nasal mucosa. There is a discharge of purulent mucus.
• X-ray of the paranasal sinuses - the image shows a slight darkening, indicating rhinosinusitis.
• Puncture is a puncture of the septum of the maxillary sinuses. This procedure helps remove some of the pus to examine the bacteria and temporarily ease breathing.

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Tests

If sinusitis is suspected, a number of tests are taken from the patient to identify the pathological process. A pregnant woman needs to take a general blood test and urine. An acute inflammatory process is indicated by a high ESR value and an increased number of granulocytes.

In addition to blood tests to determine the disease, additional tests are performed: a nasal swab to check for sensitivity to antibiotics, an X-ray of the sinuses, and a CT scan of the facial part of the skull. Nasal and sinus cultures are mandatory. If an allergic nature of rhinosinusitis is suspected, allergy tests are taken from the patient to determine the allergen.

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Instrumental diagnostics

Diagnosis of inflammatory lesions of the nasal mucosa is a complex process that involves the use of various methods. Instrumental diagnostics allows us to clarify the presence of pathology.

• Rhinoscopy is an examination of the nasal sinuses using mirrors. If the disease is acute, then swelling of the mucous membrane of the middle nasal passage and diffuse hyperemia of the middle turbinate on the affected side are observed. The bacterial form is defined as a stagnant accumulation of pus, hyperplasia, polyps on the mucous membrane.
• Radiography – pathology looks like a darkening on the image. The image is taken in different projections to obtain a clearer result. Radiological features of different forms of sinusitis make it possible to determine the morphology of the disease.
• Diaphanoscopy is the illumination of the affected maxillary sinuses using electric light, a Voyachek diaphanoscope or a Hering bulb. This method determines inflammation only in the case of unilateral damage.
• CT is a type of X-ray that provides more accurate information about the presence of the disease.
• Echosinusoscopy is an ultrasound examination of the nasal sinuses that has no contraindications. The examination is permitted to be performed during pregnancy.

Differential diagnosis

In its symptoms, sinusitis is similar to other diseases, so differential diagnostics should be used to identify it. Let's take a closer look at what diseases rhinosinusitis should be differentiated from:

• Wegener's granulomatosis is an autoimmune pathology in which granulomas form in the walls of blood vessels. According to medical statistics, this disease causes damage to the maxillary sinuses and ENT organs in 90% of patients.
• Immotile cilia syndrome is an autosomal recessive disorder that is associated with recurrent ENT and cardiovascular disease.
• Ataxia-telangiectasia is a genetic disease that develops against the background of primary immunodeficiency. The disease provokes recurrent sinusitis and sinusitis, pulmonary infections.
• Nasal polyposis - rhinosinusitis recurs in patients with a tendency to hyperallergic reactions in the nasal cavity. The pathology is associated with bronchial asthma.

Inflammation can develop due to diseases that have a distant relation to the nasopharynx. Such pathologies include gastroesophageal reflux disease, various dental diseases, adenoiditis. Since there are many differential diagnoses, only an otolaryngologist should diagnose the disease.

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Treatment maxillary sinusitis in pregnancy

Elimination of inflammatory diseases during pregnancy is a complex and lengthy process, since expectant mothers are contraindicated to use most drugs. Treatment of sinusitis during pregnancy can be carried out by the following methods:

• Puncture of the nasal sinuses is the most optimal method of treating rhinosinusitis. It involves puncturing the paranasal passage with a special needle and sucking out the purulent contents with a syringe. After that, a medicinal solution with disinfectant properties is poured into the emptied cavity. The procedure relieves some of the painful symptoms and facilitates nasal breathing.
• Antibiotic therapy is an effective method of treatment, carried out as prescribed by a doctor. For rhinosinusitis during pregnancy, the following drugs can be used: Augmentin, Spiramycin, Cephalosproin, Azithromycin. Antibiotics are not used in the early stages of pregnancy.
• Nasal lavage (cuckoo method) – this procedure does not require special punctures. Washing is carried out by moving liquids. The pregnant patient should take a horizontal position so that the head is lower than the rest of the body. After this, the doctor gradually pours an antiseptic solution into one nostril and sucks out the purulent liquid from the other. During the procedure, the patient should say "cuckoo", since this sound creates negative pressure in the nasal cavity. During the procedure, you cannot inhale, since all the liquid with pus can get into the respiratory tract.

Prevention

It is much easier to prevent any disease than to treat it. This is especially important during pregnancy, when the female body is very weakened. Prevention of ENT diseases and sinusitis in particular involves strengthening the immune system. It is necessary to avoid hypothermia and do breathing exercises to enrich the body with oxygen. Do not forget about proper nutrition, which helps prevent many diseases.

There is a set of preventive measures for sinusitis, the main goal of which is to ensure normal mucus drainage from the maxillary sinuses and stimulate local immunity.

• Regular nasal rinsing cleanses the mucous membranes from potential harmful microorganisms. During the procedure, you can use a solution of sea salt or chamomile infusion.
• Breathing exercises help improve air exchange in the nasal sinuses. Close one nostril, take a deep breath through the other and exhale through the mouth. It is recommended to do 8-10 approaches for each nostril up to 5 times a day.
• Massage of the nasal sinuses improves their blood circulation and mucus discharge, increases local immunity. If the immune system is greatly weakened, it is recommended to use immunomodulators that increase the body's resistance to viruses, bacteria and infections.

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Forecast

Sinusitis during pregnancy is a serious disease, without proper treatment it can lead to serious complications. The prognosis of the disease depends on the results of its diagnosis, the form of inflammation and the characteristics of the patient's body. If the acute form of rhinosinusitis is subject to treatment, the prognosis is favorable. Purulent inflammation has a less good prognosis, as it can lead to brain damage and death.

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