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Asthma and pregnancy

Asthma is a disease of the airways of the lungs. Asthma is characterized by a reversible narrowing of these air passages. The narrowing limits the flow of air to the lung tissue. Asthma affects almost 7 percent of pregnant women. According to a National Asthma Education Group for the Centers for Disease Control and Prevention (CDC), asthma is one of the most common diseases that can complicate a pregnancy. In some cases, diagnosis of asthma is not made until a woman

becomes pregnant. How asthma affects a woman during pregnancy varies, one-third of women experience no change in their symptoms of asthma. one-third of pregnant women experience more severe symptoms of asthma, one-third of pregnant women experience improved symptoms of asthma. Symptoms may become more severe between 29 and 36 weeks of pregnancy.

During pregnancy, asthma or asthma episodes will become worse for an estimated one-third of pregnant women, particularly women who have severe asthma. One-third will experience an improvement in their condition and another third will experience no change in the disease. Worsening is likely to occur during 24 to 36 weeks of pregnancy, and asthma severity will usually return to how it was before the pregnancy within three months of the baby's birth. The disease can cause complications for both mother and child if not properly controlled during pregnancy. Asthma complications for an expectant mother may include high blood pressure and preeclampsia. Preeclampsia is a disorder that occurs when high blood pressure is accompanied by fluid retention and leaking of protein into the mother's urine. It can potentially damage her kidneys, brain, liver and eyes. If the condition results in seizures, it can be deadly for both the mother and baby. Risks of uncontrolled asthma for the baby include premature birth, low birth weight, slow growth and stillbirth.

In general, asthma is tolerated well during pregnancy and has minimal impact on the developing infant. Severe asthma attacks can drastically lower the amount of oxygen in the mother's blood. If severe attacks are frequent or prolonged, the baby may grow very slowly and may be smaller than expected. Overall, there may be a slight increased risk to the baby, but the effect is small and should not be exaggerated. Pregnancy does not have a predictable effect on asthma. Individuals may improve, remain unchanged or become worse. In general, the patients whose asthma becomes worse tend to be the ones with severe disease prior to becoming pregnant. The majority of medications used in treating asthma do not harm the developing baby. In general, the pregnant woman should remain on the pre-pregnancy medicines. Severe asthma attacks are dangerous and requires prompt medical attention.

Having asthma does not necessarily mean having a complicated pregnancy. With proper management of the asthma and appropriate medical care during the pregnancy, most women who have asthma can experience healthy pregnancies. The key to a successful pregnancy for asthma sufferers is symptom management. Maternal asthma that is adequately controlled during pregnancy does not increase the risk of maternal or infant complications.

Treating asthma properly during pregnancy is important. Uncontrolled asthma can lead to decreased oxygen intake for the mother, which, in turn, affects the fetus. Uncontrolled asthma causes a decrease in the oxygen in the mother's blood. Since the fetus gets oxygen from the mother's blood, asthma can lead to fetal blood oxygen. Normal growth and development require a constant supply of oxygen, which again underscores the need to manage the symptoms. Studies indicate a correlation between uncontrolled asthma and babies with a lower birth weight. In rare cases, the extremely hard coughing that accompanies an attack can cause premature labor, or can cause the placenta to separate from the uterus.

Excellent medications are available for treating asthma and other allergic diseases, and although no medication can be proven entirely safe for use during pregnancy, the potential risks of the medications are lower than the risks of uncontrolled asthma. Inhaled asthma medications are generally preferred since they have a more localized effect with only small amounts entering the bloodstream. Time-tested older asthma medications are often recommended since there is more experience with their use during pregnancy. Medication use is limited as much as possible during the first trimester when the baby is developing the most, although birth defects due to medications are rare, causing no more than 1 percent of all birth defects. Medications that can be used during pregnancy also are considered safe during labor, delivery and when nursing. A nursing mother can lower the concentration of a medication in breast milk by taking medication 15 minutes after nursing or three or four hours before a baby's feeding. If an asthma patient is currently receiving allergen immunotherapy (allergy shots) for the treatment of asthma and allergies, it can be carefully continued during pregnancy. Immunotherapy should not be initiated during a pregnancy. All asthma patients should discuss the use of asthma and allergy medication during pregnancy with their doctor.

More information on asthma

What is asthma? - Asthma is a chronic inflammatory respiratory disease characterized by periodic attacks of wheezing, shortness of breath, and a tight feeling in the chest.
What types of asthma are there? - Types of asthma include child-onset asthma, adult-onset asthma, exercise-induced asthma, cough-variant asthma, occupational asthma, nocturnal asthma.
What's bronchial asthma? - Bronchial asthma is a disease of the lungs in which an obstructive ventilation disturbance of the respiratory passages evokes a feeling of shortness of breath.
What is exercise-induced asthma? - Exercise-induced asthma is a form of asthma that some people have during or after physical activity. Exercise-induced asthma is common.
What is adult-onset asthma? - Adult onset asthma generally is the onset of asthma for the first time in someone of middle age or older. Adult-onset asthma develops after age 20.
What is status asthmaticus? - Status asthmaticus is a severe asthma episode that does not respond to standard treatment. Status asthmaticus is caused by severe bronchospasm.
What causes asthma? - Asthma is caused by inhaling an allergen that sets off the chain of biochemical and tissue changes leading to airway inflammation, bronchoconstriction, and wheezing.
What're the asthma triggers? - Many risk factors have been linked to triggering asthma attacks. There are two basic types of asthma triggers, allergic triggers, non-allergic triggers.
Asthma and allergy - Asthma attacks (worsening of asthma symptoms) can be triggered by allergies. Allergy is the leading cause of asthma.
What is an asthma attack? - An asthma attack occurs when the small and medium-sized airways become inflamed and constricted after being exposed to a trigger.
Asthma in children - Asthma is the most common chronic condition of childhood. Asthma symptoms can interfere with many school activities for children.
Asthma and pregnancy - During pregnancy, asthma or asthma episodes will become worse for an estimated one-third of pregnant women, particularly women who have severe asthma.
Asthma in adults and older people - Identifying asthma in the elderly can be difficult because asthma symptoms can be confused with symptoms of heart or lung diseases.
What're the complications of asthma? - Uncontrolled asthma in pregnant women puts them at higher risk for complications that can include early labor, hypertension, gestational diabetes.
What are the symptoms of asthma? - The symptoms of asthma include labored breathing, constriction of the chest, coughing and gasping usually brought on by allergies.
What're the warning signs of asthma? - Most people with asthma have warning signs before symptoms appear. There are many warning signs of an asthma episode.
How is asthma diagnosed? - The diagnosis of asthma is made on the basis of typical symptoms and signs. Positive allergy tests support a diagnosis of asthma.
What're the treatments for asthma? - Treatment of asthma is aimed at avoiding known allergens and respiratory irritants and controlling symptoms and airway inflammation through medication.
What quick relief (rescue) medications cure asthma? - Short-acting beta-agonists are the most commonly used asthma rescue medications. Anticholinergics are another class of asthma drugs.
Long-term asthma control medications - Combinations of steroids and other medications are effective for both treating and preventing asthma attacks in patients with moderate to severe asthma.
What're asthma inhalers? - Most asthma drugs are inhaled using special devices or nebulizers. Two common types include dry powder asthma inhalers and metered-dose asthma inhalers.
What're asthma nebulizers? - Asthma nebulizers can be used with all classes of inhaled medications but are most commonly used with short-acting beta2 agonists and ipratropium bromide.
How to control acute asthma attacks? - Acute asthma is an acute exacerbation of wheezing, unresponsive to usually effective therapy and necessitating care in an emergency room or hospital ward.
How to manage chronic asthma symptoms? - The aims of management are to recognize asthma, to abolish symptoms, to restore normal or best possible long term airway function.
What asthma relievers are available? - Asthma reliever is a drug that provides relief from asthma symptoms and is the most commonly used asthma medication.
What asthma preventers are available? - Asthma preventers are to be used twice a day regardless of whether your child has symptoms of asthma.
What's the treatment for childhood asthma? - The goals of asthma therapy are to prevent child from having chronic and troublesome symptoms, to maintain child's lung function.
What's the treatment for asthma in the elderly? - Diagnosis and treatment of asthma can be more complicated in people age 65 and older than in those who are younger.
What can be done to prevent asthma? - Avoiding known allergens and respiratory irritants can reduce asthma symptoms. People with asthma should minimize risk for respiratory tract infections.
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