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Asthma During Pregnancy

Many people may not be aware that asthma is one of our country’s most common diseases and it does not just affect children. In fact, every day 27,000 adults miss work due to asthma, with 4,700 heading to the Emergency Department due to an attack. For women who are pregnant and also dealing with the management of asthma, it can present its own challenges. However, it is important to remember that having asthma does not necessarily mean having a complicated pregnancy. With proper management of asthma and appropriate medical care during the pregnancy, most women who have asthma can experience healthy pregnancies.

Asthma is also one of the most common diseases that can complicate a pregnancy. In some cases, a diagnosis of asthma is not made until a woman becomes pregnant. How asthma affects a woman during pregnancy varies, including:

•         One-third of women experience no change in their symptoms of asthma.

•         One-third of pregnant women experience more severe symptoms of asthma.

•         One-third of pregnant women experience improved symptoms of asthma.

•         Symptoms may become more severe as weight increases with pregnancy.

Treating asthma properly during pregnancy is important. Uncontrolled asthma can lead to decreased oxygen intake for the mother, which, in turn, affects the fetus. Uncontrolled asthma can lead to any of the complications listed below.

Possible Complications for the Mother

Asthma, when not controlled, can put undue stress on the mother as well as on the fetus. Lack of oxygen will not only deprive the mother, but also the baby. Other complications from uncontrolled asthma for the mother include:

•         Preeclampsia (also known as toxemia in pregnancy). A disorder of pregnancy characterized by increased blood pressure, water retention, and protein in the urine.

•         Gestational hypertension. This is high blood pressure during pregnancy

•         Hyperemesis gravidarum. A pregnancy disorder characterized by protracted vomiting, weight loss, and fluid and electrolyte imbalances.

•         Vaginal hemorrhage. This is bleeding through the vagina

•         Induced and/or complicated labor. The onset of labor to deliver the baby and/or labor that may cause complications for the mother or baby.

Possible Complications for Baby

Lack of oxygen to the baby from the mother can lead to many health problems in the fetus, including:

•         Perinatal mortality

•         Intrauterine growth retardation. Poor fetal growth in the womb, causing the baby to be smaller than normal for its gestational age.

•         Preterm birth

•         Low birthweight

•         Neonatal hypoxia. Inadequate oxygen for the baby

Asthma Medications During Pregnancy

Most asthma medications are not harmful to the fetus or to the nursing baby. In fact, uncontrolled asthma may actually put the mother and baby at far greater risk than the medication used to control asthma. Always consult with your health care for a diagnosis and to develop a specific asthma treatment plan tailored to your individual symptoms.

Reduce the Risk of an Asthma Attack during Pregnancy

The American Lung Association recommends a pregnant woman take the following steps to reduce the risk of having an asthma attack during her pregnancy:

•         Avoid asthma triggers, including tobacco smoke and other irritants.

•         Continue asthma medications throughout the pregnancy, labor and delivery, as advised by your health care provider.

•         Exercise with moderation (use medication properly if you have exercise-induced asthma and consult your doctor before beginning an exercise program).

•         Make sure to get a flu shot, if you will be in your second or third trimester of pregnancy during the influenza (fall-winter) season.

When should pregnant women seek emergency medical treatment?

Even with a proper asthma management plan in place, pregnant women should be aware of certain warning signs that may indicate an asthma attack, such as:

•         Current medication does not provide rapid improvement of symptoms.

•         Improvement from medications is not sustained as long as previously sustained.

•         Breathing becomes more difficult.

•         Fetal kick count decreases, which may indicate fetal distress.

Always talk with your health care provider about what asthma attack warning signs to look for and when to seek emergency medical treatment.