Bronchial asthma in pregnancy
Journal Title: Postępy Nauk Medycznych - Year 2010, Vol 23, Issue 5
Abstract
Bronchial asthma is the most chronic illness of the respiratory tract in pregnant patients. Many changes of the respiratory system take place in pregnant women which can influence on the course of the disease. In one-third of the cases we observe exacerbation, alleviation in another one-third and no changes among the rest of the patients. Exacerbations take place most commonly between 24th and 36th week of the pregnancy in the group of patients with severe type of asthma. Diagnosis and monitoring of the disease are quite the same in pregnant and non-pregnant patients. The treatment procedures and drugs used in pregnant patients are the same like in the rest of the population. When we give “antiasthmatic” drugs to the pregnant women we have to remember about few rules. The medicines are to be used in the smallest possible doses controlling the symptoms. Inhaled drugs (eg. cromones, anticholinergic medicines, beta-agonists, methylxantines) are safe as offer quite small exposition on the fetus. We have to be careful with oral and intravenous medicines (beta-agonists, steroids, methylxantines) because they can achieve dangerous concentration in fetus’ blood. Glucocorticosteroids are the drugs with the best effectiveness in disease controlling and exacerbations prevention. Budesonid is the safest for the patients in the beginning of the treatment. Short-acting beta-agonists are the drugs of choice in severe exacerbations, long-acting together with inhaled steroids offer very effective asthma control. Anticholinergic drugs can be used in aggravations of the disease. Methylxantines are not preferred for pregnant patients, but usage with steroids can be considered. Antileucotriens and cromones are not contraindicated as they were effective before pregnancy.Poor controlled bronchial asthma can cause severe risk for both mother and fetus.
Authors and Affiliations
Ada Sawicka, Ewa Marcinowska - Suchowierska
Keywords
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