Pregnancy and asthma are not mutually exclusive. This combination is found in one woman in a hundred. Asthma is a chronic disease of the respiratory system, which is accompanied by frequent bouts of coughing and choking. In general, the disease is not an absolute contraindication for bearing a child.
It is necessary to closely monitor the health of pregnant women with such a diagnosis in order to identify possible complications in time. With the right treatment tactics, childbirth takes place without consequences, and the child is born absolutely healthy. In most cases, a woman is selected low-toxic drugs that help stop seizures and ease the course of the disease.
Pregnancy and bronchial asthma
This disease is considered the most common among the pathologies of the respiratory system. In most cases, asthma during pregnancy begins to progress, and symptoms become more pronounced (short-term attacks of suffocation, cough without phlegm, shortness of breath, etc.).
An exacerbation is observed in the second trimester of pregnancy, when hormonal changes occur in the body. In the last month, a woman feels much better, this is due to an increase in the amount of cortisol (a hormone produced by the adrenal glands).
Many women are interested in whether it is possible for a woman with such a diagnosis to become pregnant. Experts do not consider asthma a contraindication for carrying a child. In a pregnant woman with bronchial asthma, health control should be stricter than in women without pathologies.
To reduce the risk of complications, you need to pass all the necessary tests during pregnancy planning and undergo complex treatment. During the period of bearing the baby, supportive drug therapy is prescribed.
Why is bronchial asthma dangerous during pregnancy?
A woman suffering from bronchial asthma during pregnancy is more likely to experience toxicosis. Lack of treatment entails the development of severe consequences for both the mother and her unborn child. Complicated pregnancy is accompanied by the following pathologies:
- respiratory failure;
- arterial hypoxemia;
- early toxicosis;
- gestosis;
- miscarriage;
- premature birth.
Pregnant women with severe asthma have a higher risk of dying from preeclampsia. In addition to a direct threat to the life of a pregnant woman, bronchial asthma has a negative effect on the fetus.
Possible complications
Frequent exacerbations of the disease lead to the following consequences:
- low birth weight in a child;
- intrauterine developmental disorders;
- birth injuries that occur when the baby is difficult to pass through the birth canal;
- acute lack of oxygen (fetal hypoxia);
- intrauterine death due to lack of oxygen.
In severe forms of asthma in the mother, children are born with pathologies of the cardiovascular system and respiratory organs. They fall into the group of potential allergy sufferers; over time, many of them are diagnosed with bronchial asthma.
That is why the expectant mother needs to be especially careful about her health when planning pregnancy, as well as during the entire period of bearing the baby. Failure to comply with medical recommendations and improper treatment increases the risk of complications.
It is worth noting that pregnancy itself also affects the development of the disease. With hormonal changes, the level of progesterone increases, due to changes in the respiratory system, the content of carbon dioxide in the blood increases, breathing becomes more frequent, and shortness of breath is more common.
As the baby grows, the uterus rises in the diaphragm, thereby putting pressure on the respiratory system. Very often, during pregnancy, a woman experiences swelling of the mucous membrane in the nasopharynx, which leads to exacerbation of asthma attacks.
If the disease manifests itself in the early stages of pregnancy, then it is quite difficult to diagnose it. According to statistics, the progression of asthma when carrying a baby is more common in severe cases. But this does not mean that in other cases a woman can refuse drug therapy.
Statistics indicate that with frequent exacerbations of bronchial asthma attacks in the first months of pregnancy, children who are born suffer from heart defects, pathologies of the gastrointestinal tract, spine and nervous system. They have low body resistance, therefore, more often than other children, they get sick with influenza, ARVI, bronchitis and other diseases of the respiratory system.
Asthma treatment during pregnancy
Treatment of chronic bronchial asthma in pregnant women is carried out under the strict supervision of a physician. First of all, it is necessary to closely monitor the condition of the woman and the development of the fetus.
In case of previously diagnosed bronchial asthma, it is recommended to replace the drugs that were taken. The therapy is based on the prevention of exacerbations of symptoms and the normalization of respiratory function in the fetus and the expectant mother.
Doctors carry out mandatory monitoring of the function of external respiration by the method of peak flowmetry . For early diagnosis of fetoplacental insufficiency, a woman is prescribed fetometry and Doppler ultrasonography of blood flow in the placenta.
Drug therapy is selected taking into account the severity of the pathology. It should be borne in mind that many drugs are prohibited for pregnant women. The group of drugs and the dosage are selected by a specialist. Most often used:
- bronchodilators and expectorants;
- asthma inhalers with drugs that stop the attack and prevent unpleasant symptoms;
- bronchodilators , help relieve coughing attacks;
- antihistamines, help to reduce the manifestations of allergies;
- systemic glucocorticosteroids (for severe forms of the disease);
- leukotriene antagonists .
The most effective methods
Inhalation therapy is considered the most effective. To do this, apply:
- portable pocket devices into which the required volume of medication is injected using a special dispenser;
- spacers , which are a special nozzle for an inhaler;
- nebulizers (with their help, the drug is sprayed, thus ensuring the maximum therapeutic effect).
Successful treatment of asthma in pregnant women is facilitated by the implementation of the following recommendations:
- Elimination of potential allergens from the diet.
- Use of clothing made from natural materials.
- Application for hygienic procedures of products with a neutral pH and hypoallergenic composition.
- Elimination of potential allergens from the environment (animal hair, dust, perfume odor, etc.).
- Carrying out daily wet cleaning in residential premises.
- Frequent exposure to fresh air.
- Elimination of physical and emotional stress.
An important stage of therapeutic therapy is breathing exercises, it helps to establish proper breathing and provide the body of the woman and the fetus with a sufficient amount of oxygen. Here are some effective exercises:
- bend your knees and pull up their chin, while exhaling through your mouth. Perform 10-15 approaches;
- close one nostril with your index finger, inhale through the second. Then close it and exhale through the second. The number of approaches is 10-15.
They can be performed independently at home; before starting classes, you should definitely consult a doctor.
Forecast
With the exclusion of all risk factors, the prognosis of treatment in most cases is favorable. Compliance with all medical recommendations, regular visits to the attending physician is a guarantee of the health of the mother and her unborn child.
In severe forms of bronchial asthma, a woman is placed in a hospital, where her condition is monitored by experienced specialists. Oxygen therapy should be highlighted among the obligatory physiotherapeutic procedures . It increases oxygen saturation and helps relieve asthma attacks.
In the later stages, drug therapy involves taking not only basic drugs for asthma, but also vitamin complexes, interferons to strengthen the immune system. During the period of treatment, it is imperative to take tests for the level of hormones that the placenta produces. This helps to monitor the dynamics of the fetus, to diagnose the early development of pathologies of the cardiovascular system.
During pregnancy, it is prohibited to take adrenergic blockers, some glucocorticosteroids , 2nd generation antihistamines. They tend to penetrate the systemic circulation and through the placenta to get to the fetus. This negatively affects intrauterine development, the risk of developing hypoxia and other pathologies increases.
Childbirth with asthma
Most often, birth in patients with asthma occurs naturally, but sometimes a caesarean section is prescribed. Exacerbation of symptoms during labor is a rare phenomenon. As a rule, a woman with such a diagnosis is placed in a hospital in advance and her condition is monitored before the onset of labor.
During childbirth, she must be injected with anti-asthma drugs, which help to stop a possible asthma attack. These drugs are absolutely safe for the mother and fetus and do not adversely affect the process of childbirth.
With frequent exacerbations and the transition of the disease to a severe form, the patient is prescribed a planned cesarean section, starting from the 38th week of pregnancy. In case of refusal, the risk of complications during natural childbirth increases, and the risk of death of the child increases.
Among the main complications that occur in women in labor with bronchial asthma are:
- Earlier discharge of amniotic fluid.
- Rapid labor.
- Complications of childbirth.
In rare cases, an attack of suffocation is possible during labor, the patient develops heart and pulmonary insufficiency. Doctors decide whether to have an emergency caesarean section.
It is strictly forbidden to use drugs from the prostaglandin group after the onset of labor, they provoke the development of bronchospasm. To stimulate the contraction of the muscular muscles of the uterus, the use of oxytocin is allowed. For severe attacks, the use of epidural anesthesia is allowed.
The puerperium and asthma
Very often, asthma after childbirth can be accompanied by frequent bronchitis and bronchospasm. This is a natural process, which is the body’s reaction to the transferred load. To avoid this, the woman is prescribed special medications; it is not recommended to use medications containing aspirin.
The postpartum period for asthma includes the mandatory intake of medications that are selected by a specialist. It should be noted that most of them tend to penetrate in small quantities into breast milk, but this is not a direct contraindication for taking during breastfeeding.
As a rule, after delivery, the number of seizures decreases, the hormonal background comes into shape, the woman feels much better. It is imperative to exclude any contact with potential allergens that can provoke an exacerbation. When all medical recommendations are followed and the necessary medications are taken, there is no risk of developing postpartum complications.
In cases of severe disease after childbirth, a woman is prescribed glucocorticosteroids . Then the question may arise about the abolition of breastfeeding, since these medicines, penetrating into milk, can harm the health of the child.
According to statistics, a strong exacerbation of asthma is observed in women 6-9 months after childbirth. At this time, the level of hormones in the body returns to normal, the cycle of menstruation may resume, the disease worsens.
Planning a pregnancy for asthma
Asthma and pregnancy are compatible concepts, provided the correct approach to the treatment of this disease. With a previously diagnosed pathology, it is necessary to regularly monitor the patient even before the onset of pregnancy and to prevent exacerbations. This process includes regular check-ups with a pulmonologist, taking medications, and breathing exercises.
If the disease manifests itself after the onset of pregnancy, then asthma control is carried out with redoubled attention. When planning conception, a woman needs to minimize the influence of negative factors (tobacco smoke, animal hair, etc.). This will help reduce the number of asthma attacks.
A prerequisite is vaccination against many diseases (influenza, measles, rubella, etc.), which is carried out several months before the planned pregnancy. This will help strengthen the immune system and develop the necessary antibodies to pathogens.