Asthma in pregnancy
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Asthma in pregnancy On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S. [2]; Lakshmi Gopalakrishnan, M.B.B.S. [3]
Overview
Asthma is one of the most common pulmonary conditions occurring during pregnancy[1] with a prevalence rate of 3.7% to 8.4% in United States during the period 1997-2001[2].
Pathophysiology
During pregnancy, due to high levels of progesterone, minute ventilatory rate is increased causing compensated respiratory alkalosis[3]. Hence the arterial blood gases may reveal a higher PO2 and lower PCO2 with mild alkalotic PH. Normal PCO2 during pregnancy is suggestive of impending respiratory failure.
Asthma is characterized by broncho-constriction or inflammation of airways with production of thick mucoid secretions.
Treatment [4]
- Monitor asthma control during all prenatal visits.
- Asthmatic symptoms worsen in about a third during pregnancy and improve in a third; hence, medications should be adjusted accordingly.
- Regular monitoring and maintenance of lung function to ensure adequate oxygen supply to the fetus.
- It is safer to treat asthma with medications than to have poorly-controlled asthma.
- Drug of choice in pregnancy:
- Albuterol is preferred to short-acting β2-agonist (SABA)
- Inhaled corticosteroid such as budesonide is preferred for long-term control of symptoms.
References
- ↑ Rey E, Boulet LP (2007). "Asthma in pregnancy". BMJ. 334 (7593): 582–5. doi:10.1136/bmj.39112.717674.BE. PMC 1828355. PMID 17363831.
- ↑ Kwon HL, Belanger K, Bracken MB (2003). "Asthma prevalence among pregnant and childbearing-aged women in the United States: estimates from national health surveys". Ann Epidemiol. 13 (5): 317–24. PMID 12821270.
- ↑ Wise RA, Polito AJ, Krishnan V (2006). "Respiratory physiologic changes in pregnancy". Immunol Allergy Clin North Am. 26 (1): 1–12. doi:10.1016/j.iac.2005.10.004. PMID 16443140.