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DESCRIPTION
Asthma is a chronic disorder with recurrent attacks of wheezing and shortness of breath. The course of asthma in pregnancy is unpredictable. One-third of women do not change, one-third there is an improvement in their asthma, and one-third experience worsening symptoms. The treatment of asthma in a pregnant woman is similar to the treatment for a non-pregnant woman. Be sure to discuss medication safety for use during pregnancy with your health care provider or midwife.
MoonDragon's Health Information: Asthma
FREQUENT SIGNS & SYMPTOMS
Chest tightness and shortness of breath.
Wheezing upon breathing out.
Coughing, especially at night, with little sputum.
Rapid, shallow breathing that is easier with sitting up.
Breathing difficulty.
Neck muscles tighten.
Severe symptoms of acute attack:
Bluish skin.
Exhaustion.
Grunting respiration.
Inability to speak.
Mental changes, including restlessness or confusion.
CAUSES
Over-activity an spasm of air passages (bronchi and bronchioles), followed by swelling of the passages and thickening of lung secretions (sputum). This decreases or closes off air to the lungs. These changes are caused by:
- Allergens, such as pollen, dust, animal dander, molds and some foods.
- Lung infections, such as bronchitis.
- Air irritants, such as smoke and odors.
- Exposure to occupational chemicals or other materials.
RISK INCREASES WITH
Other allergic conditions, such as eczema or hay fever.
Family history of asthma or allergies.
Exposure to air pollutants.
Smoking.
Use of some drugs, such as aspirin.
Stresses (viral infection, exercise, emotional upset, noxious odors, cigarette smoke).
PREVENTIVE MEASURES
Avoid known allergens and air pollutants.
Take prescribed preventive medicines regularly (unless your midwife or health care provider advises differently); don't omit them when you feel well. Find asthma alternative substitutes, if possible, if medications are considered unsafe for the developing baby (many are considered Teratogens and may cause problems with fetal development if taken at all and/or if doses are high enough).
Avoid aspirin and other non-steroidal pain killers.
Investigate and avoid triggering factors.
EXPECTED OUTCOME
Symptoms can be controlled with treatment and strict adherence to preventive measures.
With good self-care, you can usually expect a normal pregnancy and a delivery without complications.
POSSIBLE COMPLICATIONS
With severe asthma, there are increased risks to the fetus including prematurity, low-birth-weight, possible death.
For the mother, complications of asthma include physical exhaustion, pneumothorax (collapsed lung), pulmonary emphysema, collapsed lung and drug hypersensitivity reactions.
TREATMENT
GENERAL MEASURES
Eliminate allergens and irritants at home and at work. If possible, keep regular medications with you at all times. Sit upright during attacks.
Don't smoke.
Stay indoors as much as possible during high allergen times and avoid exposure to cold, especially if exercising.
Psychotherapy or counseling, if asthma is stress-related.
Emergency-room care and hospitalization may be required for severe attacks (which occur in only a few pregnancies).
Labor and delivery are monitored carefully to assess pulmonary function. Vaginal delivery is considered best, unless circumstances dictate a cesarean delivery. Avoid labor drugs, if at all possible, to prevent drug-related reactions.
Additional information available from the: Asthma & Allergy Foundation of America
1717 Massachusetts Ave. Suite 305
Washington DC 20036
(800) 7-ASTHMA
MEDICATION
As needed, the following may be prescribed:
Expectorants to loosen sputum.
Bronchodilators to open air passages (theophylline, terbutaline); best tolerated as inhalers, but can be given orally.
Cortisone drugs by inhaler or nebulizer, which have fewer adverse reactions than oral forms.
Intravenous cortisone drugs (emergencies only) to decrease the body's allergic response.
Antihistamines (e.g., cromolyn sodium or nedocromil) by nebulizer. These are preventive drugs.
Find and use alternatives to drugs, if possible.
ACTIVITY
Stay active, but avoid sudden bursts of exercise and strenuous exercise activities. If an attack follows exercise, sit and rest. Sip warm water.
Bronchodilators often prevent exercise-caused asthma.
Swimming is perhaps the best exercise for asthmatics.
DIET
Eat a well balanced diet. Your midwife may give you some Nutritional Guidelines to follow.
Avoid foods in which you have a sensitivity or allergy.
Drink plenty of fluids daily to keep secretions loose.
NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...
You or a family member has questions about asthma and pregnancy.
You have an asthma attack that doesn't respond to treatment. This is an emergency! Call 911 and get to your nearest emergency room for treatment, which may include a corticosteroid injections, nebulizer treatments and possibly oxygen therapy.
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
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