Maria Karnaushkina: “The severity of the course of bronchial asthma during pregnancy depends on the women themselves”

Bronchial asthma (BA) is a known and widespread disease. Modern drugs can well control its course. However, even if a woman completely controls the course of bronchial asthma and she does not affect the quality of her life, everything changes when she is going to become a mother. There is a responsibility not only for their health, but also for the health of the unborn baby. On the questions are answered by Maria A. Karnaushkin , MD, Ph.D., assistant of the Department of Hospital Therapy № 2 Medical Faculty First MGMU them I. M.                   Sechenova, a pulmonologist of the highest category.

– Can a woman with asthma give birth to a healthy baby? – In most cases, AD is not a contraindication for pregnancy, but its uncontrolled course and frequent exacerbations can lead to complications in the mother and child.   

– What happens to a woman’s respiratory system during pregnancy? – During pregnancy to the level of oxygen in the blood are increased requirements aimed at satisfies creation needs of the growing child. The entire respiratory system switches to the operating mode, fully OJEC ensures, the increasing demands. This mechanism works both in a healthy woman and in a pregnant woman with a controlled course of bronchial asthma. If the disease is not controlled, then the body feels a lack of oxygen, and the mother’s organism takes this missing oxygen from the unborn child, which can lead to a delay in its development or other diseases. So, when nekontro liruemom bronchial asthma during pregnancy in 7,4-14,2% of cases develop prezh devremennye birth in 48% – toxicosis, in 26% there is a threat of termination of pregnancy. The frequency of cesarean section in women with uncontrolled asthma over zna considerably higher than that of the healthy, and is 28%.    

– Changing whether the nature of bronchial asthma in the future mother and on what it depends? – The nature of the course of bronchial asthma during pregnancy does not always change . In 1/3 of women, the disease is more severe, in 2/3 it becomes easier or does not change at all . The course of severe and uncontrolled forms of bronchial asthma usually worsens . In the set by God the severity of the disease during pregnancy depends on the women themselves, from the first, observe whether they are hypoallergenic mode, perform whether recommen dations doctor.     

“When nekontro liruemom bronchial asthma during pregnancy in 7,4-14,2% of cases develop prezh devremennye birth in 48% – toxicosis, in 26% there is a threat of termination of pregnancy.”     

– How to reduce the likelihood of developing asthma in a baby? – Fulfilling simple recommendations, it will be possible to avoid the deterioration of the course of the disease in the mother and reduce the risk of developing bronchial asthma in the child. The development and severity of bronchial asthma are directly related to the degree of air pollution. If you have the opportunity to at least temporarily leave the city and live outside it, then do it. The most common cause of AD development and exacerbation is allergy. Removal of aggressive agents and allergens is a prerequisite for the treatment and prevention of bronchial asthma in mother and her unborn child. Therefore, if you are allergic to flowering trees or grasses, then in the period of flowering is better to change the climate and leave the area. If this is not possible, then during this period it is recommended to visit the open air as little as possible and not leave the city.  

If you are allergic to any animals – do not keep them at home. Particular attention should be paid to the issue of smoking wome us during pregnancy. Recent studies have shown that the risk of asthma in predisposed to her child in a 3-4-fold higher in the CE myah where the mother smokes.          

– How will the medical treatment of asthma affect the development of the baby? – This question worries all parents. Very often, the fear of side effects of the drugs used makes women refuse to use them . In the first place, you have to understand that the most unfavorable facto rum, affecting the development of the child is the lack of oxygen, which develops in time attacks of breathlessness from uncontrolled course of the disease.  

All attempts to “endure” attack harm is much greater than in a timely manner received a bronchodilator and maintenance inhaled anti-inflammatory therapy, teacher stvuyuschaya exacerbation of asthma. For most anti-asthma drugs, there is no adverse effect on pregnancy . Information about their safety was obtained during experiments on animals and in lengthy clinical trials.        

“The risk of asthma in predisposed to her child in a 3-4-fold higher in the CE myah where the mother smokes.”    

The main reason for the development of asthma attacks is chronic inflammation of the bronchi. And while there is inflammation, asthma attacks are repeats ryatsya, and the disease will worsen. Therefore, the main principle of the treatment of bronchial asthma is the implementation of long-term anti-inflammatory inhalation therapy.   

Two groups of drugs are used to treat bronchial asthma: drugs for emergency care (relieving symptoms) and prophylactic drugs for long-term control of bronchial asthma. 

There are drugs used to provide emergency care for exacerbation of bronchial asthma. If the seizures are rarely disturbed (not more often than 1-2 times a week) and there are no nightly attacks of labored breathing, then you can limit yourself to the use of inhaled drugs to relieve seizures. The use of theofedrine and ephedrine group drugs during pregnancy is strictly prohibited. Intravenous administration of aminophylline is allowed only with the ineffectiveness of inhalation therapy.     

– What should I do if an asthma attack develops? – First of all, no panic! Where no matter arose asthma attack, you first need to calm down, telling myself: “I can cope with the storm!”. When you have an attack, you need to sit down or stand up better, spreading your chest so that you can use the inhaler correctly. Try to take a shallow breath and exhale slowly through the folded lips. Use a bronchodilator inhaler (usually take 2 breaths with an interval of 10-15 minutes). If there is a nebulizer at home, then you can and should inhale the bronchodilator medicine through it. Take a warm, preferably alkaline drink (mineral water should be gas-free). If the attack is not stopped after 15-20 minutes, repeat the inhaler every 20 minutes for an hour. With an overwhelming attack of suffocation for more than an hour, you must urgently call a doctor.  

After a strong attack, it is advisable to consult a doctor. 

– When is emergency medical assistance required? – If within 20 minutes there is no response to a bronchodilator inhaler and there is no marked improvement within 1.5-2 hours. By the way, for the relief of bronchial asthma attack is not to be applied expectorant drugs that enhance the cough, sedatives and antihistamines, as well as thermal procedures (eg, mustard, banks) on the chest, are also capable of Uhud sewing state. 

“Advice: take inhalers 4 hours before feeding the baby, then the concentration of the drug in the blood will be minimal.”    

– What are the drugs for long-term control of bronchial asthma? – In as the basic (long-term) protivovospa -inflammatory treatment of asthma during pregnancy preferred inhaled glucocorticosteroids. According to modern data, these drugs do not increase the risk of fetal abnormalities and most effectively treat the inflammatory process in the bronchi. 

The number of complications during pregnancy is associated not only with the severity of the course of bronchial asthma, its drug therapy, but with the number of its exacerbations.     

– How do births usually occur in women with this disease? – Delivery is usually done on time and through the birth canal. The risk of complications in this case does not differ from healthy women. Caesarean section is performed only according to strict indications. The course of the postpartum period in women in labor with bronchial asthma does not differ from healthy ones. It will only be necessary to continue taking anti-asthma drugs that a woman took during pregnancy.   

You can breast-feed your baby, the only advice: take inhalers 4 hours before feeding, then the concentration of the drug in the blood will be minimal.    

I wish you all a happy pregnancy, a safe birth, healthy children and happy motherhood.   

event_note March 7, 2020

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