Asthma pregnant. Diagnosis, treatment

Asthma is the most common respiratory disease in pregnant women, affecting up to 12% of them. Approximately 1/5 of pregnant asthmatic women experience exacerbations during pregnancy. Uncontrolled, suboptimally treated asthma poses a great risk to the mother and fetus. Associated mortality occurs. It is important to distinguish it from pathological shortness of breath, requiring a thorough clinical examination. For most pregnant women, the effect has not been established. Good medication for asthma during pregnancy plays an important role. Children born to mothers with uncontrolled asthma with severe gestational exacerbation have a high risk of low birth weight. Poorly controlled asthma in the mother is associated with a high incidence of preterm labor, preeclampsia, and cesarean section. Treatment of asthma in pregnant women The importance of quitting smoking during pregnancy should be emphasized and the desire to quit smoking should be supported. Effective exchange of information before conception and during pregnancy plays an important role in eliminating concerns about taking drugs in pregnant women. Asthma treatment is safe for pregnant women; while poorly controlled asthma is a serious danger to the mother and fetus. The close relationship between the doctor and the obstetrician involved in the treatment is of great importance. Long-term treatment of asthma in pregnant women. There is no evidence that standard treatment of asthma, if properly administered, is dangerous in pregnant women. Treatment of chronic asthma in pregnant women should be aimed at maximizing control and minimizing the risk of an acute attack. The use of antagonists of leukotriene receptors in pregnant women should be limited in women who took them already before conception, in which asthma is not adequately controlled without them. Leukotriene receptor antagonists should not be used in pregnant women. All other asthma medications are considered safe. Self-monitoring and regular inspection play an important role in detecting any changes and preventing them at an early stage. Acute asthma attacks in pregnant women. Exacerbations occur in 20% of pregnant asthmatic women. These are usually mothers with severe, poorly controlled asthma. Exacerbations most often occur at the end of the second trimester. An asthma condition should be treated immediately in a hospital according to standard guidelines for asthma in adults. Systemic glucocorticoids should not be discarded in pregnant women. It is necessary to monitor the fetus and maintain maternal saturation of more than 95%. Asthma in childbirth. Usually, treatment should be continued if possible during labor. Theoretically, increased stress during childbirth increases the risk of hypoadrenalism in women who regularly take corticosteroids. Hydrocortisone, 100 mg intravenously after 6 hours, should be administered to women in childbirth who daily took 7.5 mg of prednisone or more daily over the previous 2 weeks. b-Adrenergic blockers, prostaglandin F2 and (in aspirin / NSAID-sensitive subjects) NSAIDs cause bronchospasm and their use should be avoided. Breastfeeding and asthma. The benefits of breastfeeding for the baby and mother are well known. All medications used to treat asthma are considered safe. During asthma treatment, there is no need to change breastfeeding.

event_note October 30, 2019

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