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Asthma is one of the most common potentially life-threatening condition
complicating pregnancy. The incidence of asthma is increasing steadily
and it is estimated that asthma currently affects 4 of pregnant
women. In rare cases asthma may occur for the first time during
pregnancy. In general well controlled asthma is not associated with
a higher risk of adverse pregnancy outcomes.
In fact the most common cause of worsening asthma in pregnancy is
due to noncompliance with medicines.
It is seen that about one third of the pregnant women with asthma
experience worsening of their asthma symptoms during pregnancy.
One third of the asthmatic women feel better during pregnancy.
Asthma exacerbations are more frequent at the beginning of the third
trimester of pregnancy and improves a few weeks before labor.
10 % of the pregnant women suffering from asthma seek emergency
care during the pregnancy.
Oxygen is vital for the well being of the mother and the fetus.
Every pregnant woman needs a proper treatment to maintain normal
lung functions and oxygen level to maintain proper oxygen supply
to the fetus.
Asthma patient should receive education about maintenance and rescue
medication, how to measure PEFR by peak flow meter, proper use of
inhalers, asthma prevention, and adherence of asthma action plan.
Patient should also learn when the asthma is worsening and when
to contact the doctor.
Spirometry is the preferred method for pulmonary function testing
during outpatient visits. However, peak expiratory flow measurement
with a peak flow meter is also adequate.
Effect of Asthma on mothers:
Pre eclampsia.
Placenta previa.
Gestational hypertension.
Prolonged hospital stay.
Fetal complications include:
Increased risk of perinatal mortality
Intra uterine growth retardation.
Low birth weight.
Neo natal hypoxia.
Other diseases mimicking asthma during pregnancy:
Mechanical obstruction
Laryngeal obstruction
COPD
Pulmonary edema
Pulmonary embolism Amniotic fluid embolism
Upper airway cough (Rhinitis, sinusitis, reflux)
Goals of asthma control during pregnancy:
The American College of Obstetricians and Gynecologists (ACOG) has
issued a practice bulletin for management of asthma during pregnancy.
The new recommendations appear in the February issue of Obstetrics
& Gynecology 2008. They are:
1. Prevent hypoxic episodes in mother there by maintaining adequate
fetal oxygenation.
2. Monitor lung functions by Spirometry preferred.
3. Avoid and controlling asthma triggers.
4. Patient education
Individualized pharmacotherapy to maintain normal pulmonary functions.
1. Control day time and nocturnal symptoms.
2. Maintain normal activity levels including exercise.
3. Prevent acute exacerbations of asthma.
4. No emergency department visit or hospitalization.
5. Avoid adverse effects of medications to mother and child.
6. Give birth to a healthy child.
http://www.asthmahelpline.com/pregnancy-asthma.htm
http://www.asthmahelpline.com
Article Source: Articledashboard.com:
Asthma and Pregnancy
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