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[Asthma and pregnancy]

E H van Haren1, I E Devies, M J Mol

  • 1Atrium, Medisch Centrum, Heerlen.

Nederlands Tijdschrift Voor Geneeskunde
|June 12, 1998
PubMed
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Physiological hyperventilation during pregnancy can cause shortness of breath. For pregnant asthma patients, controlled asthma management is crucial for fetal well-being, with specific safe medication guidelines.

Area of Science:

  • Obstetrics and Gynecology
  • Pulmonology
  • Perinatology

Background:

  • Pregnancy induces physiological hyperventilation, leading to perceived shortness of breath due to reduced lung volumes and increased tidal volume.
  • Hormonal changes (progesterone) and increased chemosensitivity to CO2 and O2 contribute to respiratory adjustments during gestation.
  • Pregnant individuals may experience fatigue, reduced exercise tolerance, orthopnea, and basal lung crepitations.

Observation:

  • Asthma symptoms in pregnant patients can exhibit variable responses, either improving or worsening.
  • Maternal alkalosis during an asthma attack can compromise fetal oxygenation by reducing uteroplacental blood flow.
  • Uncontrolled asthma poses a significant risk to fetal health, outweighing the risks associated with appropriate anti-asthma medication use.

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Findings:

  • Specific asthma medications are categorized by safety profiles during pregnancy, parturition, and breastfeeding.
  • Cromoglycic acid and ipratropium are considered safe options for managing asthma in pregnant individuals.
  • Short-acting beta-sympathomimetics, inhaled and systemic corticosteroids, and theophylline (from the second trimester) are relatively safe.

Implications:

  • Judicious use of anti-asthma medications is recommended to mitigate adverse effects on the fetus.
  • Long-acting beta-sympathomimetics are generally advised against due to potential risks.
  • Effective asthma management during pregnancy is essential for both maternal and fetal health outcomes.