Nasal polyps in pregnancy

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

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

After the birth of the child, the hormonal background stabilizes, so the polyps can resolve on their own without any additional interventions. If this does not happen, they can be removed, cauterized, or undergo complex treatment, which is usually quite effective after childbirth. Repeated growths are extremely rare.

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Causes nasal polyps in pregnancy

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

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Pathogenesis

Almost all polyps initially form in the sinuses. Hyperplasia of the mucous membrane occurs, as a result of which it continues to grow and gradually goes beyond the sinuses and fills the nasal cavity. The exact reason for such intensive growth has not yet been identified.

Most specialists, based purely on their own practical experience, can assume that polyps are a consequence of frequent inflammatory processes, in which the mucous membrane does not have time to fully recover and return to its normal structural and functional state. In addition, infection often accumulates in the sinuses, which can directly or indirectly support the inflammatory process, causing irritation and an allergic reaction. This does not allow the mucous membrane to fully recover. As a result, it continues to grow and increase in size.

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Symptoms nasal polyps in pregnancy

In this case, the development of the polyp occurs in three stages. At the first stage, polyps form in the nasal sinus and become inflamed. During this period, they practically do not cause any inconvenience to a person. At the second stage, they increase in size and begin to partially exit the sinuses, blocking normal breathing. At the third stage, the polyp completely exits the nasal sinus, as a result of which the nasal passage is completely blocked. This is the most dangerous stage, which can lead to severe difficulty in nasal breathing and sleep apnea.

The woman experiences, first of all, severe nasal congestion. Runny nose, chronic inflammation and swelling may appear. The mucous membrane increases significantly in size, the nasal septum is curved. Local immunity is initially impaired, and over time, a systemic immune disorder may develop.

The woman has difficulty breathing; at the third stage, she is practically unable to breathe through her nose.

Stages

There are three stages of polyp development. At the first stage, the mucous membrane grows, the polyp is quite localized, small in size. At the second stage, it partially blocks the nasal cavity, making breathing difficult. The third stage is considered the most dangerous, when the nasal passage is completely blocked, nasal breathing stops completely. At this stage, the only way to solve the problem is surgical removal of the polyp.

With stage 1 polyps, discomfort is usually felt only by the mother. Nasal breathing is difficult, but it can still be fully compensated for by breathing through the mouth. At the second and third stages, the fetus also experiences problems and discomfort. The blockage of the nasal passage by a polyp significantly reduces the supply of oxygen to the tissues, and accordingly, not only the supply of oxygen is disrupted, but also the removal of carbon dioxide. In this case, measures must be taken, since a long-term disruption of oxygen supply can lead to intrauterine growth retardation, fetal hypoxia, and premature birth.

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Complications and consequences

The most severe consequences include olfactory dysfunction, nasal voice, and constant snoring. Gradually, a lack of oxygen is felt, hypoxia develops, which leads to metabolic disorders, lack of oxygen in the internal organs and tissues. At the same time, the amount of carbon dioxide in the blood increases, headaches and migraines develop.

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Diagnostics nasal polyps in pregnancy

In order to carry out the correct treatment, it is necessary to first correctly diagnose and determine the cause of the pathology. The method of endoscopy of the nasal cavity and sinuses is quite informative. Many modern clinics use the method of video endoscopy. They make it possible to determine the severity of the pathology and the extent of the spread of the pathological process.

Computer or magnetic resonance imaging is often used to visualize the condition of the nasal cavity and paranasal sinuses. In addition, these methods can provide information about the condition of the bones, nasal septum, and surrounding soft tissues.

To detect polyps, the most commonly used methods are examination of the nasal passages and computed tomography of the paranasal sinuses. A consultation with a dentist and allergist may also be required. Based on the diagnostic results, an optimal treatment regimen is selected. The doctor selects therapy taking into account the degree and severity of the pathological formation, its cause, the duration of pregnancy, the characteristics of the course, and the general condition of the mother and fetus.

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Treatment nasal polyps in 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 treatment methods are used. Surgical methods of examination are considered more effective, which make it possible to completely remove the polyp. Additionally, methods aimed at preventing repeated growths (relapses) of the disease are required. It is recommended to remove using an endoscopic or laser method. After surgery, conservative therapy is used aimed at restoring the mucous membrane.

At first, they try to use conservative methods, and only if they are ineffective, they resort to surgical methods. The basis of conservative treatment is antibacterial and antiallergic agents, topical steroids. Drugs should be prescribed with caution, having previously checked their effectiveness and safety. For example, before prescribing antibiotics, it is advisable to conduct a bacteriological study with the isolation of the pathogen and the selection of a sensitive antibiotic and its optimal concentration. Steroids should be prescribed only after 14 weeks.

Conservative methods are used when conservative therapy is ineffective, the nasal passages are completely blocked and there is a risk of fetal hypoxia, severe snoring, loss of smell, dizziness and frequent headaches. Also indicated are hearing loss, profuse nasal discharge, especially bloody, rapid growth of polyps and suspicion of their malignant nature.

Mostly, surgeries are performed after childbirth. The indication for performing surgery during pregnancy is complete blockage of the nasal passages. It is better to perform the surgery in the period of 24-30 weeks, since during this period the risks are minimized. There is every chance for successful removal of polyps, quick recovery. The risks for the child are also minimal: this will not affect the further development of the fetus. The surgery is performed only if the woman feels well. After the polyps are removed, it is necessary to take measures to prevent their growth.