Pharyngitis in pregnancy

Overview

Pharyngitis is a sore throat caused by swelling and irritation of the back of the throat. During pregnancy, it is very common and usually not harmful to you or your baby.

Yes, pharyngitis is very common during pregnancy. Hormonal changes and a slightly weaker immune system make pregnant women more likely to catch colds and other infections.

It affects pregnant women, especially in the first and second trimesters when the immune system is most changed.

Symptoms

Common symptoms

• Sore, scratchy, or painful throat
• Pain when swallowing
• Red or swollen tonsils
• Hoarse voice
• Mild fever (under 38°C / 100.4°F)
• Runny or stuffy nose
• Cough

Symptoms in children

• This article focuses on pharyngitis in pregnancy. For children, symptoms may also include a red throat, fever, refusal to eat or drink, and fussiness.

Symptoms in older adults

• Older adults may have similar symptoms but can experience more severe tiredness or confusion. However, this article is specifically about pregnancy.

Causes

Main causes

• Viral infections (most common – cold viruses, flu, or COVID-19)
• Bacterial infections (like Group A Streptococcus, which causes strep throat)
• Irritants such as cigarette smoke or dry air

Risk factors

• Being pregnant – hormonal changes and a slightly lower immune defence
• Being around people who are sick
• Smoking or exposure to secondhand smoke
• Chronic allergies or sinus infections

When to see a doctor

See a doctor urgently if:

• If you have trouble breathing or swallowing
• If you have a high fever that does not go down with paracetamol
• If you are unable to keep down fluids
• If you have severe pain that does not improve with home remedies

Book a routine appointment if:

• If your sore throat lasts longer than 3–5 days
• If you have white patches on your tonsils that do not go away
• If you are worried about your symptoms

Diagnosis

Your doctor will ask about your symptoms and examine your throat. They may also check your temperature and listen to your breathing.

Tests that may be done

• A throat swab – a cotton bud is gently rubbed on the back of your throat to test for bacteria like Streptococcus.
• A rapid strep test gives results in minutes, or a culture takes 24–48 hours.

What to expect at your appointment

The exam is quick and painless. The throat swab may cause a brief gagging feeling. Your doctor will explain the results and discuss the best treatment for you and your baby.

Treatment

Treatment depends on whether the cause is viral or bacterial. Most cases are viral and do not need antibiotics. The goal is to relieve symptoms and keep you comfortable.

Self-care at home

• Drink warm liquids like tea with honey (honey is safe during pregnancy, but not for babies under 1 year)
• Gargle with warm salt water (half a teaspoon of salt in a glass of warm water) several times a day
• Use a cool-mist humidifier to keep the air moist
• Suck on ice chips or sugar-free throat lozenges
• Rest your voice as much as possible
• Get plenty of rest and sleep

Medical treatments

If a bacterial infection is confirmed, your doctor will prescribe antibiotics that are safe to take during pregnancy. For pain and fever, you may be advised to use paracetamol (acetaminophen) – it is generally considered safe, but always check with your healthcare provider. Do not take ibuprofen, aspirin, or any other painkillers without first asking your doctor or midwife.

Living with this condition

Most sore throats get better in 3–7 days. During that time, focus on rest and comfort. Avoid smoking and smoky places. Stay away from people who are sick to prevent additional infections.

Lifestyle tips

• Wash your hands often with soap and water
• Cover your mouth and nose when coughing or sneezing
• Avoid sharing cups, utensils, or toothbrushes
• Keep your home well-ventilated

Diet and exercise

Eat soft, cool foods like yogurt, smoothies, and soups. Avoid spicy, salty, or acidic foods that can irritate your throat. Mild exercise, such as walking, is fine if you feel up to it, but rest when you feel tired.

Mental health and emotional wellbeing

Being sick during pregnancy can be worrying. You might feel anxious about your baby’s health or frustrated because you cannot take many medicines. It is normal to feel this way. Talk to your partner, midwife, or a trusted friend about your feelings.

Prevention

You cannot always prevent pharyngitis, but you can lower your risk by washing your hands often, avoiding close contact with people who have colds or sore throats, and not touching your face.

Vaccines

The flu vaccine is recommended during pregnancy and can help prevent flu-related pharyngitis. Make sure you are up to date with other routine immunizations. Talk to your doctor about what vaccines are right for you.

Complications

If left untreated

• If bacterial pharyngitis (strep throat) is left untreated, it can very rarely lead to rheumatic fever (which affects the heart) or kidney problems.
• Untreated infection can cause dehydration if you cannot drink enough fluids.
• In pregnancy, a high fever may increase the risk of preterm labour, but this is uncommon with proper care.

Long-term outlook

The outlook is excellent. Most sore throats in pregnancy resolve on their own or with simple treatment. With proper care and monitoring, both you and your baby will do well. Your healthcare provider will help ensure you stay healthy.

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