Antenatal care

Exacerbations of asthma requiring medical intervention occur in about 20% of pregnant women and about 6% will require hospitalisation.² Regular evaluation and monitoring of asthma control is, therefore, recommended throughout pregnancy.^1,3 Poorly controlled asthma increases the risk of pre-eclampsia, preterm birth, low birth weight and perinatal mortality. Good asthma control can reduce these risks.¹

The goals of management during pregnancy are to maintain asthma control so as to ensure the oxygen supply required for normal foetal development, as well as to maintain maternal health and quality of life. The pharmacological treatment of asthma during pregnancy should be the same as for non-pregnant women. (See Medication during pregnancy and lactation)

• Doses of ICS should be the minimum necessary to control symptoms and maintain normal or best lung function.
• Peak expiratory flow monitoring and regular review of asthma every 4-6 weeks is recommended.³ This can provide reassurance for the pregnant woman and her healthcare providers. Close cooperation between all health professionals caring for the pregnant patient is important to ensure the best asthma management.
• Acute asthma exacerbations may reduce the amount of oxygen available to the foetus. Any deterioration in symptoms should be managed promptly.
• Trigger factors should be avoided or minimised where possible. Minimise exposure to known allergens and irritants.

Poorly controlled asthma increases the risk of pre-eclampsia, prematurity, low birth weight and perinatal mortality. (III) Good asthma control reduces these risks. (IV) The pharmacological treatment of asthma during pregnancy should be the same as in non-pregnant women. (IV) Women who are planning a pregnancy and already using ICS should switch to budesonide, a Category A drug. (IV)

Content Created (Thursday, 16 November 2006)