Asthma during Pregnancy

Pregnancy does not have a uniform effect on the symptoms of asthma. There could be pregnancy associated asthma or an asthmatic lady may represent aggravation of asthma symptoms during pregnancy. Asthma is probably the most common chronic illness that severely affects around 8% of pregnant women. Pregnancy alters the respiratory and cardiovascular physiology and these alterations may lead to severity of asthma. Proper control of asthma in pregnant women could significantly reduce the complications of perinatal period. The underlying mechanisms responsible for the altered state of asthma due to pregnancy are unknown. Poorly controlled asthma during pregnancy may lead to perinatal mortality and complicate labour. Prevalence of low birth weight of babies and preterm births in asthmatic women as compared to non-asthmatic women have also been documented.

Worsening of asthma during pregnancy may be due to large number of contributing factor. There could be exposure to allergens, infections of the upper respiratory tract, gastroesophageal reflux, non compliance or poor compliance of medication or unwanted use of drugs. Patients with severe asthma prior to conception and patients whose asthma has worsened during previous pregnancies could be labeled as high risk patients. Acute asthma episodes during pregnancy may significantly decrease fetal oxygenation and need medical intervention. However, the management and treatment of asthma are the same in pregnant women as in non-pregnant women and men. Following guideline need special considerations during pregnancy to prevent asthma exacerbations during pregnancy:

1. Avoid intentional exposure to known allergens like pollens, dust, animal furs, feathers and certain food stuffs.



2. Strict medical consultations are needed throughout the pregnancy for optimal control of
   asthma.



3. Delay in the diagnosis and treatment of should be avoided.



4. Smoking cessation is a must.



5. Other health problems like rhinitis, gastric reflux and any infection of upper respiratory tract should be treated effectively.



6. Pulmonary function (assessment or expiratory air flow with Spirometer) should be assessed at least once in a month.



7. Periodic antenatal fetal surveillance should be got done by a specialist.