Asthma in Pregnancy

Asthma in pregnancy
Presented by: Murad Ali

Muhammad Arif
Discipline : Emergency Care
INTRODUCTION
•  Asthma is a chronic inflammatory disease of the

airways that causes airway hyper- responsiveness,
mucosal edema, and mucus production
Asthma is characterized by chronic airway
inflammation and airway hyper-
increased
responsiveness leading to symptoms of wheeze,
cough, chest tightness and dyspnoea.
INTRODUCTION CONTD…..
• Asthma differs from the other obstructive lung

diseases in that it is largely reversible, either
spontaneously or with treatment.
• Patients with asthma may experience symptom-
free periods alternating with acute
exacerbations, which last from minutes to hours
or days.
Epidemiology
• The worldwide prevalence of a sthma is increasing,

• and with 3 –12 per cent of pregnant women affected
• by asthma, it is the most common chronic disease
• in pregnancy. Asthma is not consistently affected by
• pregnancy and it is reported that, during pregnancy,
• the severity of asthma remains stable in one-third of
• women, worsens in another third and improves in the
• remaining third.
The effects of asthma
on the fetus
• that most episodes occur between 24 and 36 weeks of

pregnancy.
• The effects of asthma on the fetus are still controversial and while
systematic reviews report that FGR is more common in women
with symptomatic asthma than in non-asthmatic women.
• Prolonged maternal hypoxia can lead to FGR and, ultimately, to

fetal brain injury.
Features of severe life-threatening asthma in
prgnancy:
• Peak expiratory flow rate ?35 per cent of predicted

• • Silent chest
• • Cyanosis
• • Bradycardia
• • Arrhythmia
• • Hypotension
• • Exhaustion
• • Confusion
What Are Triggers of Asthma?
• Respiratory infections such as a cold, flu,

bronchitis, and sinusitis: Both bacterial and viral
infections can trigger an asthma attack.
• Cigarette smoke (firsthand or secondhand)
• Smoke from cooking or wood fires
• Emotional upset
What Are Triggers of Asthma?
• Food allergies
• Allergic rhinitis (hay fever or seasonal allergies)
• Changes in weather, especially cold, dry air
• Exercise
• Strong smells, sprays, perfumes
• Allergic reactions to certain chemicals
• Allergic reaction to cosmetics, soaps, shampoos
• Allergic reaction to irritants, such as dust/dust mites, molds, feathers,
pet dander, etc.
DIAGNOSIS
• History taking
• A complete family, environmental, and occupational history is
essential.
•Family history : History of asthma in family
•  Environmental history : seasonal changes, high pollen counts,
climate changes (particularly cold air), and air pollution,
• Industrial chemicals and plastics, biologic enzymes (eg, laundry
detergents), animal and insect dusts and secretions.
Physical examination
• wheezing all over the lung

•breathlessness and cough.
•Cyanosis
INVESTIGATIONS
• Lung function tests/ pulmonary function

• test : Shows variable airflow limitation
•  Blood tests :shows increase in the number of eosinophils in

peripheral blood .
•Sputum tests The presence of large
• numbers of eosinophils in the sputum is a more useful diagnostic tool.
• Chest X-ray
• Skin tests Skin-prick tests (SPT)
Management of asthma in pregnancy
• Pregnancy is a time to improve asthma care

• Encourage smoking cessation
• Ensure patient education regarding condition and
• adequate use of medications
• Ensure optional control and response to therapy
• throughout pregnancy
• Manage exacerbations aggressively and avoid delays in
treatment
• Manage acute attacks as in non-pregnant individual
• Offer a multidisciplinary team approach
Which Medications Treat and Manage Asthma during Pregnancy?
• During pregnancy, inhaled corticosteroids are the

mainstay for long-term control.
• Examples include budesonide and beclomethasone
• Leukotriene inhibitors: These drugs are
considered safe during pregnancy.
• Examples are montelukast , zafirlukast, and
zileuton.
• Long-acting beta-agonist inhalers:

• these medications often are used in combination with
inhaled steroids for severe or night time symptoms.
• Examples of long-acting beta-agonists include
salmeterol and formoterol .
• They also are used to prevent
exercise-induced asthma.
• Methylxanthines:
• They are not used as much as the other long-term
medications because they don't work for as many people.
The most widely used example is theophylline . Because
pregnancy can change the concentration of this
medication in the bloodstream, checking levels of
theophylline may be required, even if you were taking it
before.
Which Medications Should Not Be Used during Pregnancy?
• Antihistamines and decongestants:

• Epinephrine and other related
medications:
• Aspirin and other nonsteroidal
antiinflammatory drugs (NSAIDs)
Except paracetamol
References
• OBSTETRICS by Ten Teachers book

• The harriet handbook 20th edition
• https://www.emedicinehealth.com/asthma_in_pregnancy/article
_em.htm#facts_about_and_definition_of_asthma_during_pregnanc
y
• Medical Author: Irina Petrache, MD
• Medical Author: Catherine Sears, MD
• Medical Editor: William C. Shiel Jr., MD, FACP, FACR
Thanks

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Asthma in pregnancy

Presented by: Murad Ali

•  Asthma is a chronic inflammatory disease of the

• Asthma differs from the other obstructive lung

• The worldwide prevalence of a sthma is increasing,

• that most episodes occur between 24 and 36 weeks of

• Prolonged maternal hypoxia can lead to FGR and, ultimately, to

• Peak expiratory flow rate ?35 per cent of predicted

• Respiratory infections such as a cold, flu,

• wheezing all over the lung

• Lung function tests/ pulmonary function

•  Blood tests :shows increase in the number of eosinophils in

• Pregnancy is a time to improve asthma care

• During pregnancy, inhaled corticosteroids are the

• Long-acting beta-agonist inhalers:

• Antihistamines and decongestants:

• OBSTETRICS by Ten Teachers book

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