Asthma is a chronic respiratory disease which causes inflammation of the airways. This results in a reduction of air flow to the lungs causing symptoms like wheezing, coughing and breathlessness. Asthma is a fairly common health problem in pregnant women which can complicate your pregnancy if not controlled properly. But with proper management of asthma and medical care, most women with asthma can experience a healthy pregnancy.
How Does Asthma Affect Pregnant Women?
Asthma in pregnant women not only affects the mother but also reduces the oxygen supply to the fetus. Uncontrolled or poorly controlled asthma can present many risks to you and your fetus. It can increase the risk of hypertension and high blood pressure during pregnancy. It can also cause Preeclampsia, a condition that causes high blood pressure resulting in damage to placenta, kidneys and brain. Asthma may also cause low birth weight or intrauterine growth restriction, especially in women who have daily symptoms of moderate asthma. Hyperemesis gravidarum, a condition in which a pregnant woman experiences more than normal vomiting during early pregnancy can also affect asthmatic pregnant women. Some other effects are complicated labor that does not start naturally.
In addition to the health problems faced by the mother, the fetus is also at risk of perinatal mortality i.e. death immediately before or after birth, preterm birth i.e birth before the 37th week of pregnancy and low weight at birth.
Treatment Of Asthma In Pregnant Women
Better control of asthma can reduce the risks of complications during pregnancy. Like non-pregnant women, pregnant women too must have a proper asthma management plan to prevent and control asthma attacks. Treatment of asthma in pregnant women should take into account the following:
• There must be proper coordination between the health professionals dealing with asthma and pregnancy, if they are different.
• Monthly check-ups to monitor lung function using spirometry or peak flow meter is necessary to ensure that adequate oxygen is being supplied to the fetus.
• Regular monitoring of fetal movements using ultrasound can help monitor fetal growth, especially in patients who have moderate or severe asthma.
• Asthma triggers like smoking and dust mites should be avoided to reduce the need for taking medicines.
• Treatment of allergies along with asthma is important for proper asthma control. Pregnant women can use inhaled corticosteroids and antihistamines at recommended doses for this purpose.
Asthma Medications In Pregnancy
Medication during pregnancy is always a cause of concern. But uncontrolled asthma can do more harm to the pregnant woman and her fetus than asthma medicines. The US Food And Drug Administration has labeled Budesonide as the safest inhaled corticosteroid that can be used during pregnancy. According to the U.S. National Asthma Education And Prevention Programme (NAEPP), patients with severe and persistent asthma can be given high-dose inhaled corticosteroids and long-acting inhaled beta-2 agonist such as Salmeterol during pregnancy. Pregnant women with moderate and persistent asthma can be given low-dose inhaled corticosteroids and long-acting inhaled beta-2 agonists while those with mild and persistent asthma can be safely treated with low-dose inhaled corticosteroids, preferably Budesonide. For those with intermittent asthma problems, there is no need of any daily medication. Short-acting bronchodilators like Albuterol can be given to provide quick relief from symptoms.
Brompheniramine, epinephrine, alpha-adrenergic compounds, docongestants other than pseudoephedrine, antibiotics like tetracycline and ciprofloxacin, immunotherapy and iodides are some of the drugs that can have an adverse impact on the health of the fetus.
Although asthma may influence pregnancy, proper management of this condition can prevent complications. Even if any exacerbations do occur, they should be treated aggressively for effective asthma control. The most important thing to remember is that asthma can be controlled during pregnancy. According to the American Medical Association, most of the asthma drugs are safe for pregnant women, provided they are taken in the recommended doses and on the advice of a health professional.