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Asthma and Pregnancy (part 2)

Asthma and Pregnancy (part 2)
By Qanta Ahmed, MD


A woman's asthma may need to be controlled with medication during her pregnancy. While many women are rightly concerned about the use of medications during pregnancy, uncontrolled asthma is a much greater hazard to the baby than any asthma medication. Maintaining proper lung function gives the baby oxygenated blood, which ensures that the baby is able to breathe and grow. The best way to achieve this is to make sure the asthma is properly treated and monitored.

Most drugs commonly used to treat asthma show no added risk in pregnant women or their developing babies. This means that most common inhalers and other asthma controlling medications are safe for you and the baby. Some studies have shown a mild risk of preeclampsia (a syndrome of high blood pressure during pregnancy) with steroid use for asthma. However, given that severe asthma may be associated with maternal and/or fetal mortality, the use of steroids is still recommended. There are some antibiotics, such as tetracyclines, sulfonamides and ciprofloxacin that must not be taken during pregnancy, but your doctor will advise you on this.

Some Common Questions
The following are a couple of questions I often hear on the topic of asthma and pregnancy.

Will my baby be OK?
With today's sophisticated medicine, infant mortality continues to improve. More and more women with chronic diseases are able to conceive and carry babies through pregnancy successfully. We see women with serious diabetes, hypertension, or asthma make a smooth transition into motherhood. If the obstetrician properly monitors the baby and there is good communication between the medical doctor and the obstetrician about the asthma, the baby is in good hands.

The most important thing you can do for your baby is to avoid cigarette smoke. When you smoke, your baby suffocates - even inhaled second hand smoke can be very harmful. You need to keep cigarettes away from your developing child. A mother who smokes is more likely to give birth to a child with low birth weight and is more likely to have a child with respiratory disease, such as asthma. And if one of the parents, either mother or father, has asthma, the risk of having a child with this condition multiplies.

What if I need a cesarean section?
Many children today are delivered by c-section, for all sorts of reasons. A cesarean section should be thought of as any other operation. For you to do well, you need to be in the best shape possible. This includes controlling your asthma. There is a little rule that is taught to doctors in training - never send a wheezing patient to the operating room. If you have been unfortunate enough to have an asthma attack when you are pregnant, then your doctor will probably suggest that you receive breathing treatments, such as nebulizers (asthma medication given in aerosolized form by facemask), before you are given anesthesia for a c-section.

How will steroids affect my delivery?
If, during your pregnancy, you have been on steroid tablets for your asthma, you physician will likely suggest that you get special burst doses of steroids close to delivery. These give you extra protection and support for your asthma and sometimes your blood pressure, while the baby is being born. Again, your doctors will determine how much medication you need.

What if I don't want to take any medications?
Many women are proponents of natural birthing and want to avoid all medications, however if you are suffering from asthma, doing so might present a substantial, avoidable risk to the baby's well-being.

After the Child is Born
Remember, just because you have asthma does not mean that your baby will too -- in fact, it's more likely that he will not. You should be able to use your usual medications now that the baby is born, but always check with your doctor. Not only is it safe for the baby to breast-feed, breast-feeding is also beneficial to your newborn baby's immune system. As your body recovers from the pregnancy and all the changes that happened in the lungs and chest normalize, your breathing will return to normal.


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