Posted by Victor E. Long, Esq.
According to a recent study published in the April 2009, New England Journal of Medicine, although uncontrolled asthma may increase the risk of adverse perinatal outcomes, women with well-controlled asthma in pregnancy generally have good outcomes. The recommendations in the article are consistent with the guidelines published by the American College of Obstetrics and Gynecology in 2008.
Avoiding allergens and irritants, such as tobacco smoke, that exacerbate asthma can improve maternal well-being and lessen the need for medication. Additional information is available thourh American College.
Specific recommendations are as follows:
- During pregnancy, it is safer for women with asthma to be treated with asthma medications than to have asthma symptoms and exacerbations.
- The clinical assessment of asthma includes both subjective evaluations as well as pulmonary function tests.
- During pregnancy, the main goal of asthma treatment is to maintain sufficient oxygenation of the fetus by preventing hypoxic episodes in the mother.
- The step-care therapeutic approach entails increasing both the number and dosage of medications as asthma severity increases.
- For persistent asthma during pregnancy, first-line controller therapy consists of inhaled corticosteroids.
- During pregnancy, budesonide is the preferred inhaled corticosteroid.
- For pregnant women with asthma, recommended rescue therapy is inhaled albuterol.
- Maternal well-being can be improved, with less need for medication, by identifying and controlling or avoiding exposure to tobacco smoke and other allergens and irritants.
- Continuing immunotherapy is recommended for women who are at or near a maintenance dose, who are not having adverse reactions to the injections, and who seem to be deriving clinical benefit.
- In general, only small amounts of asthma medications enter breast milk. During breast-feeding, use of prednisone, theophylline, antihistamines, inhaled corticosteroids, beta2-agonists, and cromolyn is therefore not contraindicated.