Asthma-In-Pregnancy

Asthma is a common condition and affects 10% of pregnant women.

It is an episodic illness i.e. there will be episodes of attack interspersed with symptom free time. Asthma results from a complex and poorly defined interaction of genetic predisposition and environmental stimulation. The basic mechanism for nonspecific bronchial hyperresponsiveness is unknown. Inflammation of the airways secondary to a trigger is the most common hypothesis

Common triggers for the attack are pollens, house-dust mites, cigarette smoke, wood smoke, air pollution, strong odours (air fresheners), occupational dust, and chemicals (paint smoke).

Various medical conditions, like upper respiratory tract viral infections, sinusitis, oesophageal reflux and worm infestations can lead to an attack.

Drugs like aspirin and nonsteroidal anti-inflammatory drugs are known to trigger an attack. Emotional stress has also been implicated as an important trigger.

It is important to have very good control of asthma during pregnancy as it can have adverse effects on the mother and fetus if it is not under control.

Various medical conditions, like upper respiratory tract viral infections, sinusitis, oesophageal reflux and worm infestations can lead to an attack.

Drugs like aspirin and nonsteroidal anti-inflammatory drugs are known to trigger an attack. Emotional stress has also been implicated as an important trigger.

It is important to have very good control of asthma during pregnancy as it can have adverse effects on the mother and fetus if it is not under control.

Effect of pregnancy on asthma.

Pregnancy by itself will not worsen or improve asthma. Patients who have mild disease may not have any change but those with severe disease may have worsening of symptoms.

Effect of asthma on pregnancy.

Severe and/or poorly controlled asthma can lead to increased Blood Pressure in pregnancy, preterm labour, growth restricted babies, low birth weight babies and higher risk of caesarean section.

Asthma does not affect the labour and delivery and the post-partum period.

Corticosteroids and beta agonists drugs are used to control asthma.

Corticosteroids are commonly prescribed. The inhaled preparations are very safe and effective in pregnancy. The oral and intramuscular preparation is used only during acute exacerbation and they should be used with caution for long term. Inhaled Beta agonists are effective and safe.

When an attack ensues then the patient should be taken to the emergency department for immediate management under the care of a pulmonologist.

Timely intervention can minimize the effects on the foetus and prevent morbidity and mortality.