[Asthma in pregnancy. Physiopathological, clinical, and therapeutic aspects]

The constantly increasing frequency of asthmatic pathologies in the general population has consequently led to a greater number of cases of bronchial asthma in pregnant women. In normal conditions the respiratory function undergoes numerous modifications in pregnancy, above all increased ventilation/minute and oxygen consumption. Likewise, asthma has a number of obviously negative effects both on the pregnant woman and the developing foetus. The clinical course of asthma may also be influenced by the start of pregnancy in various unforeseeable ways. All these aspects highlight the considerable difficulties of treating bronchial asthma during pregnancy, not to mention the medicolegal responsibility which the obstetrician and doctor must assume. In this respect it is vitally important to emphasize that pregnant women suffering from asthma must be treated in the same way as those who are not pregnant, and both prophylactic and anti-dysreactive pharmacological treatment must be administered at an early stage right up until the time of birth. Since these drugs are above all of the aerosol type, their potential secondary and/or teratogenic effects is considered extremely low and to all extents absolutely favourable in relation to the cost/benefit ratio. In fact, it is certainly less damaging for the pregnant woman to take these drugs, even in the first trimester of pregnancy, rather than run the risk of an attack of asthma with unforeseeable results. It is therefore enormously important to ensure that both the doctor and pregnant woman are adequately informed regarding preventive and pharmacological strategies for bronchial asthma.