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The nursing management of asthma is a comprehensive approach that relies heavily on the expertise and dedication of healthcare professionals. It involves thorough assessment, accurate diagnosis, strategic planning, effective implementation, and diligent evaluation. By meticulously following this step-by-step process, healthcare professionals play a crucial role in providing the best possible care and treatment for patients with asthma, enhancing their overall health and well-being.
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Interventions for managing asthma in pregnancy.

Emily Bain1, Kristen L Pierides, Vicki L Clifton

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Managing asthma during pregnancy requires careful consideration of interventions. While some non-pharmacological approaches show promise, more research is needed to confirm their effectiveness and safety for both mothers and infants.

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Area of Science:

  • Obstetrics and Gynecology
  • Pulmonology
  • Clinical Pharmacology

Background:

  • Asthma is a common pregnancy complication, linked to adverse maternal and perinatal outcomes.
  • Adequate asthma control significantly improves maternal and infant health.
  • Suboptimal asthma control in pregnancy stems from concerns about medication risks and management uncertainties.

Purpose of the Study:

  • To evaluate the impact of pharmacological and non-pharmacological interventions for asthma management in pregnant women.
  • To assess effects on maternal and fetal/infant outcomes.

Main Methods:

  • Systematic review of randomized and quasi-randomized controlled trials.
  • Searched Cochrane Pregnancy and Childbirth Group's Trials Register and Cochrane Airways Group's Trials Register.
  • Included trials assessing pharmacological and non-pharmacological asthma management strategies.

Main Results:

  • Eight trials involving 1181 women were included; overall quality was moderate.
  • Pharmacological interventions: Inhaled magnesium sulphate showed potential for acute asthma exacerbations; inhaled corticosteroids and theophylline showed no clear benefits or harms.
  • Non-pharmacological interventions: A fractional exhaled nitric oxide (FENO)-based algorithm reduced asthma exacerbations; pharmacist-led management and progressive muscle relaxation (PMR) showed some positive effects on asthma control.

Conclusions:

  • Limited evidence from moderate-quality trials prevents firm conclusions on optimal asthma management in pregnancy.
  • Inhaled magnesium sulphate for acute asthma warrants caution due to small trial size and unclear quality.
  • Non-pharmacological strategies show promise but require larger, well-powered trials to confirm efficacy and safety for maternal and infant outcomes.