Asthma
and Pregnancy
The risks when asthma and
pregnancy go together is something that many women want to know about.
Asthma is a fairly common breathing disorder, but it is not terribly
common
in pregnancy with only about 1% to 4% of pregnant women having
asthma. Asthma in pregnancy doesn’t necessarily
follow a strict pattern of increasing or decreasing in intensity.
Its severity is very dependent upon the individual woman.
Asthma
and Pregnancy
Doctors and midwives will do an initial physical exam and personal
health history with the pregnant woman, and it is during this time that
the woman should divulge the information about her asthma and her
current treatments. The doctor or midwife will review the
information and discuss options for treatment of asthma in
pregnancy. There is no good way to predict whether or not
asthma will cause an issue for a woman during her pregnancy.
Sometimes women who have asthma find that in pregnancy their typically
severe asthma has lessened in severity. Or a woman can find
that her asthma in pregnancy is much worse. It really just
depends upon the woman. If a woman has had asthma in a
previous pregnancy, the outcomes of asthma and that pregnancy can be
used as a predictor of how her asthma will be in this
pregnancy. By three months postpartum, a woman’s
asthma has typically returned to its pre-pregnant state.
Asthma
and Pregnancy Risks
Asthma is associated with many prenatal issues and could warrant the
need for your doctor or midwife to keep a close eye on your health and
wellness in pregnancy. Asthma has been associated with:
- * Hyperemesis
gravidarum
(excessive vomiting)
- * Pre-term
delivery
- * Chronic
hypertension
- *
Pre-eclampsia
- * Low birth
weight
infants
If you asthma is under good control with lifestyle choices and
medications, the risks listed above are largely mitigated.
Treatment
Treatment options for asthma include albuterol, metaproterenol, and
terbutaline. None of these drugs have been implicated in
causing issues with the baby’s development. The benefit of
using them definitely outweighs the risks associated with a full-blown
asthma attack. When a woman has a severe asthma attack, the
baby suffers because of the decreased oxygenation of the blood reaching
the baby through the placenta. The risk of any possible side
effect is far outweighed by the benefit of using the medication for
prevention of asthma attacks in pregnancy.
Asthma
and Pregnancy During Labor
While asthma attacks are rare in labor, there are some things that can
stimulate a severe asthma attack during labor. They include:
- * Emotional
responses
- * Inhalation
of
irritating antigens
- * Fears of
the unknown
path of labor
- * Use of
medication to
help with pain
- * Use of
certain
prostaglandins
Women should continue taking their asthma medication even in labor, and
if a cesarean section is required the use of epidural anesthesia is
much preferred over inhaled sedation due to asthma attack
risk. Women should remain very well hydrated in labor to
prevent any bronchospasm. Medications like Demerol and
morphine should not be used to reduce pain sensation in labor because
they can cause depression of the pulmonary system and trigger an asthma
attack.
Outlook
for Asthma and Pregnancy
The outlook for women
who have asthma in pregnancy is very good. If a woman is up
front and honest with her doctor or midwife, the provider can make a
plan that will assist her during her pregnancy, labor, and
birth. A woman should be careful to avoid any known triggers
during pregnancy and keep a healthy and positive outlook.
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