Pregnancy and Asthma

The chances of a pregnant patient having asthma are one out of 100, according to the American College of Allergy, Asthma and Immunology. Even still, treating the small percentage of women who will be affected by asthma during gestation is important. Pregnant patients with asthma need to be aware of their condition and the possible effects on themselves and their babies, but they do not need to be fearful. Remind patients to maintain control of asthma by continuing their medications and avoiding triggers like known allergens, such as dust and tobacco smoke. Continued use of medications to regulate asthma helps a pregnant patient maintain a healthy eating plan, adequate sleep and emotional stability. Learning the ways asthma affects a mother and child are helpful when preparing for the OBGYN board review.

Risks

A worsening asthma condition, which typically occurs during weeks 29 to 36, is the lack of oxygen flowing through the patient’s body and to the baby is cause for concern. Although asthma does not always worsen during pregnancy, according to the Mayo Clinic, poorly controlled asthma may affect the mother in ways such as:

• Increased morning sickness
• Higher risk of vaginal bleeding
• Elevated blood pressure
• Greater concern of preeclampsia or damage to organs
• Possible enhanced labor difficulties

For the baby, uncontrolled asthma concerns may result the following conditions:

• Reduced fetal growth
• Premature delivery
• Lower birth weights

Medication & Tests

Pregnant women should not begin allergy shots during pregnancy, but if the shots were started before pregnancy, she can continue the series. Medications should be adjusted if the patient’s asthma symptoms improve during pregnancy, then monitored throughout the duration. Patients should also continue to take their prescribed asthma medication during pregnancy unless it is a systemic glucocorticoid which has been linked to:

• Elevated risk of oral clefts
• Premature delivery
• Preeclampsia
• Decreased birth weights

If your patient’s asthma is severe, you can schedule a few tests to check on the baby’s health, such as ultrasounds to watch growth or a biophysical profile to monitor heart rate, growth, movement, muscle development and amniotic fluid levels.

Tips

Provide patients with current information to help them control their asthma and reduce pregnancy and/or fetal complications. The National Asthma Education and Prevention Program, from the U.S. Department of Health and Human Services, recommends monitoring your patients asthma at every visit. The preferred method is spirometry, but peak flow meters will provide accurate measurements. Patients are typically the best indicators of their own condition, so remind them to track fetal movements. If a reduction in movement is felt, especially after an asthmatic episode, she should contact you immediately. Inhalers should be used according to a doctor’s recommendations and patients should avoid asthmatic triggers such as pollen, dust or animal dander.

A successful pregnancy and delivery is the goal for your patients with asthma. This is a possibility with adequate monitoring, medication adjustments and helping patients avoid episodes.