Jan 12
12
Asthma Control – Bronchial Asthma In Pregnancy
International Asthma day 2011 in Malmö
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Is obstructive disease of airways with bronchospasm & increased airway secretions.
Incidence- 1%
Course in pregnancy-
In about one quarter, disease improves, in another quarter it worsens & in remaining half it remains unchanged.
Effect on foetus-
Slightly increased perinatal mortality & IUGR. Severe cases with maternal hypoxaemia lead to foetal hypoxia, which lead to increased perinatal mortality.
Diagnosis-
Of chronic asthma is made by wheeze particularly at night, breathlessness, cough. Acute attack can occur at any time. It is diagnosed by the physician under whose care she remains.
Antenatal care & treatment-
Patient is at high risk pregnancy, thus is referred to obstetric specialist. Antenatal care is given as per Dawn rule of ten care.
Treatment of asthma- Maintenace therapy is continued as per physician- bronchiodialators, asthma inhalers.
For acute episode, she is hospitalized, oxygen is given.
Delivery- Vaginal delivery is safer. Caesarean section under epidural anaesthesia is done on obstetric indications. Patients receiving corticosteroid in pregnancy is given inj. Wymesone 4 mg at early labour & is repeated after 8 hours.
Written by Dr.Simran