After pregnancy, a woman's body becomes extra sensitive. When symptoms like nasal congestion, runny nose, and sneezing frequently occur, many pregnant women are confused: Is it a common cold or a specific type of pregnancy rhinitis? Because medications during pregnancy require extra caution, misjudging the cause can lead to unnecessary medication or delayed treatment. This article provides a practical guide for distinguishing between a cold and pregnancy rhinitis based on four aspects: symptom characteristics, onset patterns, accompanying manifestations, and examination methods, along with targeted relief methods.
Core Symptom Differences
Both colds and pregnancy rhinitis primarily present with nasal symptoms, but colds are often accompanied by systemic discomfort, while the symptoms of pregnancy rhinitis are more localized to the nasal cavity.
Purity of Nasal Congestion and Runny Nose
Pregnancy rhinitis: Nasal congestion is persistent, often affecting both nasal cavities, alternating or simultaneously, and worsens at night when lying flat (due to the increased mucosal congestion caused by body position). Nasal discharge is often clear, profuse, and odorless, and symptoms are temporarily relieved by blowing the nose. Colds: Nasal congestion may initially be unilateral and gradually worsen as the condition progresses. Nasal discharge may initially be clear and watery, but after 2-3 days, it often turns yellow-green purulent (indicating bacterial infection) and may be streaked with blood (due to mucosal damage from frequent nasal blowing).
Case: A 28-year-old pregnant woman developed bilateral nasal congestion at 20 weeks of gestation and required mouth breathing at night, but had no fever or sore throat. Nasal endoscopy revealed diffuse mucosal edema, consistent with pregnancy rhinitis. Another 30-year-old woman developed nasal congestion accompanied by yellow purulent discharge and headaches. A blood test revealed elevated white blood cells, ultimately leading to a diagnosis of a bacterial cold.
Sneezing Triggers
Pregnancy rhinitis: Sneezing is often paroxysmal, associated with exposure to cold air, odors, or changes in body position (such as rising from a recumbent position), and is infrequent (3-5 times per day).
Colds: Sneezing is often frequent (several to dozens of times per hour) in the early stages of infection, often accompanied by catarrhal symptoms such as throat itching and tearing. This is related to viral stimulation of nasal nerve endings.
Comparison of Pathogenesis
The onset of colds and pregnancy rhinitis differ significantly. Observing the course of the disease and potential triggers can aid in diagnosis.
Self-Limited Course
Pregnancy rhinitis: Symptoms vary with gestational hormone fluctuations, typically gradually worsening after 12 weeks of gestation, peaking in the second and third trimesters (24-36 weeks), and resolve spontaneously within 2-4 weeks after delivery, with no tendency to recur.
Colds: The course of the disease is self-limited. The common cold typically lasts 7-10 days, while the flu may last up to 2 weeks. If symptoms persist for more than 10 days or relapse after remission, be wary of complications such as sinusitis.
Seasonal and Environmental Associations
Pregnancy rhinitis: Symptoms are not seasonal, but may be exacerbated by dry air, pollution, or temperature fluctuations. Pregnant women who spend extended periods in air-conditioned environments or are exposed to dust mites are more susceptible to attacks.
Colds: They are most common in winter (associated with increased activity of respiratory viruses) but can occur year-round. Recent exposure to colds, contact with someone with a cold, or fatigue (such as staying up late or traveling long distances) are key triggers.
Associated Symptoms
Colds are often accompanied by systemic symptoms, while the "additional manifestations" of pregnancy rhinitis are often nasal-related.
Presence or Absence of Systemic Symptoms
Pregnancy rhinitis: Systemic symptoms such as fever, fatigue, and muscle aches are absent, and the pregnant woman's mental state, appetite, and ability to move are generally unaffected.
Colds: Commonly associated with symptoms include a low-grade fever (37.3-38°C), headache, sore throat, and cough; influenza patients may experience severe symptoms such as a high fever (≥39°C), chills, and body aches.
Ear, Nose, and Throat Symptoms
Pregnancy rhinitis: May be accompanied by mild ear congestion (due to nasal congestion leading to Eustachian tube dysfunction), but no hearing loss. Some pregnant women experience dry throat due to prolonged mouth breathing, but no sore throat.
Colds: Commonly associated with pharyngeal congestion and dysphagia, and in severe cases, can lead to otitis media (manifested by ear pain and hearing loss). Influenza patients may experience hoarseness and conjunctivitis (red eyes and tearing).
Medical Examination
When symptoms are atypical or difficult to distinguish, medical examinations can provide a definitive diagnosis.
Complete Blood Test and C-Reactive Protein (CRP)
Pregnancy rhinitis: A complete blood test will show normal white blood cell, neutrophil, and lymphocyte counts, with a CRP <10 mg/L (indicating no inflammatory response).
Colds: Viral colds typically have normal or slightly low white blood cell counts and an elevated lymphocyte ratio; bacterial colds may show elevated white blood cell and neutrophil counts, with a CRP >50 mg/L.
Nasal Endoscopy and Sinus CT
Pregnancy rhinitis: Nasal endoscopy reveals diffuse congestion and edema of the nasal mucosa, which is lavender or pale, with no purulent discharge. Sinus CT scan is normal (CT scans are generally avoided during pregnancy and are only performed when complications are suspected).
Colds: Nasal endoscopy may reveal acute mucosal congestion, with possible purulent discharge in the middle nasal meatus or olfactory cleft. Sinus CT scan may show thickening or effusion of the sinus mucosa (suggesting sinusitis).
Targeted Relief Methods
Depending on the different characteristics of colds and pregnancy rhinitis, pregnant women can take the following relief measures. The core principle is to avoid drug abuse and prioritize physical therapy.
Relief Methods for Pregnancy Rhinitis
Normal Saline Nasal Irrigation
Benefit: Removes allergens, pathogens, and inflammatory mediators by irrigating, reducing mucosal edema.
Procedure: Use a medical nasal irrigation device (such as a squeeze bottle) and individually packaged normal saline solution 2-3 times daily. Use a water temperature of 37-40°C. Breathe open your mouth during irrigating to avoid choking.
Case Study: After two weeks of consistent nasal irrigation, a 32-year-old pregnant woman's nasal congestion score decreased from 8 (severe) to 3 (mild), and her nighttime sleep time increased by two hours.
Humidifier and Air Purifier
Benefit: Maintains indoor humidity at 40%-60%, reduces mucosal dryness and irritation, and filters allergens such as dust mites and pollen.
Recommendation: Open windows twice daily for ventilation (15 minutes each time). Avoid using aromatherapy or sprays (which may aggravate symptoms). Hot compresses and steam inhalation
Benefit: Promotes local blood circulation and relieves mucosal congestion.
How to: Apply a warm towel to the nose for 10 minutes, three times daily; or inhale steam from a cup of hot water (be careful to avoid burns) for 5 minutes each time.
Posture adjustments
Benefit: Relieves nighttime nasal congestion.
Recommendation: Elevate the head of the bed 15-20 degrees when sleeping, or sleep on your side (with the side with the more severe nasal congestion facing up).
Cold Relief Methods
Get adequate rest and hydration
Benefit: Boosts immunity and promotes viral excretion.
Recommendation: Drink 1500-2000ml of water daily (can be divided into multiple small amounts), avoid caffeinated beverages, and ensure 8-10 hours of sleep.
Rinse with saline solution and use nasal drops
Benefit: Relieves sore throat and nasal congestion. Procedure: Rinse your mouth with warm salt water (1 cup of warm water + 1/4 teaspoon of salt) 3-4 times daily. For nasal congestion, moisten your nasal cavity with saline nasal drops (such as sea salt water), 2-3 drops per nasal canal 3 times daily.
Physical Cooling
Effect: Controls low-grade fever.
Method: Wipe the forehead, armpits, and groin with a warm washcloth. Avoid using alcohol or ice water (which may induce chills).
Use Medication with Caution
Principle: Use only when symptoms are severely disruptive and strictly follow a doctor's instructions.
Safe Medications: Acetaminophen (for fever and pain relief), honey (for cough relief, recommended in late pregnancy), pseudoephedrine (for short-term relief of nasal congestion, requiring medical evaluation).
Contraindicated Medications: Aspirin, ibuprofen, cough suppressants containing codeine, and combination cold medicines (which may contain multiple contraindicated ingredients).
Although the symptoms of a cold and pregnancy rhinitis are similar, pregnant women can accurately distinguish between the two by observing the symptom pattern, course of illness, accompanying manifestations, and medical examinations. If symptoms are consistent with pregnancy rhinitis (e.g., persistent nasal congestion, no systemic symptoms, and a course related to pregnancy), physical therapy such as saline irrigation and humidified air can provide relief. If a cold is suspected (e.g., accompanied by fever, sore throat, and purulent rhinorrhea), seek medical attention promptly and use safe medication under a doctor's guidance. Remember: pregnancy is not trivial; accurate diagnosis is the prerequisite for safe medication use, and scientific care is key to symptom relief.
