1 Manufacturers of all OTC proprietary products marketed for the treatment of hay fever symptoms recommend that pregnant women should be supplied under a doctor's supervision, despite the fact that many products are licensed GSL and available for self-selection in supermarkets and other non-pharmacy outlets. This patient should be referred back to her obstetrician or GP. In the meantime, to help with the nasal congestion, you could suggest that she tries steam inhalations. 

2 Hay fever is caused by allergic hypersensitivity reactions in the nasal mucosa and the conjunctiva of the eye, associated with the presence of pollens in the atmosphere, mainly in the summer months. The most common causes are tree pollens in spring, grass pollen in summer, and mugwort and chrysanthemum pollen and fungal spores in autumn. (For the pathophysiology of allergic reactions, see OTC Casebook in the March issue of Independent Community Pharmacist.)