by V. Kumar

Created on: October 08, 2009   Last Updated: October 10, 2009

'Asthma in pregnancy' sounds quiet scary and dreadful. Now if you add the possible side effects of medicines to this matrix, it begins to feel dreadful. Actually, it is quiet manageable, and the knowledge that most ladies who face this daunting task are able to get through it unhurt should be a major reassurance.

Asthma is one of the most common serious ailments observed in pregnancy. As per the National Asthma Education and Prevention Program, it is observed in 4 to 9% of pregnant women. In some cases, it is observed for the first time during pregnancy, making it more important that the patient quickly learns to cope with it in routine.

COMPLICATIONS THAT CAN HAPPEN

Asthma in pregnancy can lead to three types of complications.

First are the complications of asthma itself. If asthma is not controlled with preventive medication, it may flare up frequently, and occasional episode may get exacerbated to the extent of a life threatening situation, which will endanger the life of both mother and the fetus. This is by far, the most important of all complications, and should be avoided at all costs.

Second are the complications of pregnancy itself. These are conditions which endanger the continuation of pregnancy, like Pre-ecalmpsia or Eclampsia. They cause risk for both mother and fetus.

Third category of complications are those arising from the adverse effects of medicines. These include genetic abnormalities of fetus like cleft lip, or reduced weight or development.

PRINCIPLES OF MANAGING ASTHMA IN PREGNANCY

1. The first principle underlying the treatment of asthma during pregnancy is the fact that the adverse effects of medicines used in treating asthma are far less dangerous compared to the complications arising from poorly controlled asthma in pregnancy. In other words, the most important complication to avoid is the worsening of asthma, and for that necessary medicines can be taken without serious side effects.

2. The medicines used for long term control of asthma are very safe, and generally safer than the acute attack of asthma. So there is no harm in regular intake of long term asthma medicines, like steroid inhalers and long term beta 2 agonists.

3. In case of worsening of symptoms, one should consult the physician at the earliest, and begin the treatment for acute attack, which is different from the long term asthma control medicines. It is also important to note that increasing the dose of regular long term medicines during worsening of symptoms or acute attack is not useful and should be avoided.

4. One of the best ways to control asthma is avoiding exposure to its triggers like dust, sudden changes in temperature, occupational exposure, infections and other allergens. Thus, in case of those with a history of moderate to severe asthma, there may be some rationale in avoiding such exposure, especially during the last trimester. For others, precautions like avoiding dusty places can be useful.

5. In the case of those whose asthma is frequently worsening due to occupational exposure, being away from the work-place for a while may be the best and most economical option in the long run.

6. Infections of the respiratory tract also worsen existing asthma. Hence one should take necessary precautions of avoiding exposure to infected individuals, hospitals, very highly crowded and polluted places. Good nutrition with adequate amount of proteins and vitamins also helps.

Thus, if one understands the principles of treating asthma in pregnancy, and does not delay consultations and treatment, it is quite possible to avoid any complications even in the presence of asthma during pregnancy.

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