The main symptoms of seasonal allergies are nasal congestion and watery discharge from the nose. In addition, some sufferers have itchy, watery eyes; sneezing; coughing; ear fullness; skin rash and itching; and worsening of asthma symptoms (wheezing).

We usually split the pregnancy into trimesters of 13 to 14 weeks each. The first trimester is the most problematic in terms of medications and congenital defects, and we try to avoid medications during this important time. After the first trimester we have a little more leeway.

Treating seasonal allergies largely depends on the symptoms. If nasal congestion is the problem, using saline nasal spray can help. With eye symptoms, astringent eye drops (such as Vasocon-A or Naphcon-A) may offer some relief. Neither of these will have systemic effects. All asthma medications except leukotriene inhibitors (such as Singulair) can be continued in pregnant women.

If medication is needed for symptoms, it should be avoided in the first trimester. Nasal steroid sprays have been shown to be the most effective, but do not help with eye symptoms. If eye symptoms cannot be controlled by drops, oral medication will be needed. Antihistamines are the drugs of choice in this case.

Of course, the best treatment for allergies is avoidance of the trigger: Keep windows closed when possible, limit outdoor activity, consider cleaning ductwork and using a HEPA filter, and vacuum carpets and drapes frequently.

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