Asthma and pregnancy: effects on the fetus, possible consequences, expert opinions

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

About 7% of pregnant women have a history of asthma. Most often, an exacerbation occurs in the second or third trimester. According to statistics, in 33% of patients the disease proceeds without drastic changes, in 28% there is an improvement and in 35% there is an exacerbation and complication. Therefore, many couples planning pregnancy are wondering how to combine pregnancy and asthma, whether the disease will affect the development of the fetus. Will it not serve as an obstacle to natural childbirth, and what else could be the consequences? The answers to these questions are presented in the article below.

What a sickness

Chronic inflammation that occurs in the bronchi is called asthma. The disease can be triggered by various pathogens, as the bronchi are very sensitive to them. In some cases, asthma is inherited. It manifests itself with a dry cough, bouts of difficulty breathing, which can be very strong. Despite the terrifying diagnosis, asthma and pregnancy are quite compatible.

Not alwaysthis disease is permanent, it can either arise or disappear, or appear only in a certain period of time. For example, many patients note that seizures occur more often at night than during the day or in the morning. Since the respiratory organs are affected, allergens that are in the air most often act as provoking factors. This also includes viral infections, poor ecology (exhaust fumes, tobacco smoke), food additives (in particular, the flavorings contained in them), household cleaners and detergents (namely fragrances). Doctors in this list include stress, anxiety, mental disorders, overwork.

Most of all, a woman may be excited about the question of how to cope with asthma attacks during pregnancy. Doctors say that the disease can manifest itself at the most unexpected moment. Therefore, it is necessary to avoid factors that provoke the development of asthma or the onset of another attack. It is highly undesirable to interrupt treatment and taking medications. An experienced specialist can suggest an alternative treatment regimen during pregnancy. This will help you avoid side effects and survive attacks.

Symptoms and stages

Knowing about the first signs of asthma during pregnancy is necessary, if only because it will allow you to take timely measures to combat an attack and prevent their further occurrence. Doctors warn that bronchial asthma develops as a result of untreated pneumonia and bronchitis. In this case, asthma attacks may be completely absent or have an episodic character. On theAt this stage, few doctors can immediately diagnose asthma. Short-term exacerbations of the disease that occur about once a week, in medical terminology, refer to the intermittent (initial) stage. The number of seizures that occur at night does not exceed two episodes per week.

The second stage of the disease is mild persistent, in which symptoms occur once a day, more than once a week, the number of nocturnal attacks is at least two per month. When there is an exacerbation of asthma during pregnancy, the disease negatively affects sleep and physical activity, they speak of the third stage. At this stage, a woman may have more than once a week attacks at night, the rest of the symptoms are repeated daily.

The last stage is the fourth, in which the pregnant woman has a nocturnal cough without sputum, noisy, wheezing, a feeling as if the throat was scratched, tightness in the chest area. During coughing, the face may acquire a bluish tint, perspiration may come out. If sputum is secreted, then most likely it is plentiful and liquid. The described symptoms should alert and encourage a woman to be examined by a doctor. An asthma attack during pregnancy that does not stop for several hours or even days is a clear signal for urgent medical attention. It is almost impossible to cope with such symptoms of the disease on your own, and the usual medications may be ineffective.

Features of the disease during gestation

The special condition of a woman,associated with bearing a baby, leaves a certain imprint. This is due to the methods of treatment, and the consequences that may affect the development of the fetus. If a woman was diagnosed with bronchial asthma during pregnancy, then the doctor should warn that it is possible to develop late toxicosis, complications in childbirth. As for the child, problems with oxygen supply also negatively affect his growth and weight gain. In pregnant women who suffer from frequent attacks and do not take any measures to eliminate them, the pressure rises, which further threatens the development of hypertension. Left unattended, the disease is also fraught with the fact that it can lead to a disease such as preeclampsia. It affects the brain, liver, placenta, kidneys.

The specialist who leads the pregnant woman for all nine months must control the effectiveness of the medicines she takes. If the usual drugs (for example, cromones) have ceased to work, then the treatment regimen should be changed. As a rule, they resort to inhalers containing hormonal components in their composition. With the initial appointment of this kind of medication, the choice usually falls on Pulmicort (budesonide). This drug has been tested in practice, about 2000 pregnant women took it during pregnancy and had a positive effect. Specialists also note that newborns had a good assessment immediately after birth and they had no signs of hypoxia, developmental delays. In short, the children were no different from those whose mothers were he althy.

Diagnosis

In order to establish a diagnosis and choose the right treatment for bronchial asthma during pregnancy, the doctor prescribes a number of studies:

• Clinical blood test.
• Microscopic examination of sputum.
• Assessment of the state of the lungs, which determines the most important indicator - forced expiratory volume and vital capacity of both lungs (spirometry).

Any other tests such as allergy testing and x-rays are not allowed during pregnancy. Therefore, when diagnosing a disease, it is necessary to undergo an examination with a doctor in advance and pass all kinds of tests even at the planning stage. You may also need to use a pneumotachometer, which allows you to evaluate the work of the lungs.

Periods of exacerbation

The main reason for the development of an attack is a decrease in tone in the bronchi, namely smooth muscles. Edema, which occurs as a result of the inflammatory process, leads to a thickening of the walls of blood vessels. In turn, the submucosal glands and goblet cells produce a viscous dense secret, which aggravates the picture of the disease. Pregnancy and asthma during an exacerbation can cause a delay in the flow of oxygen through the placenta.

A doctor who monitors a woman during the period of bearing a baby must constantly monitor breathing and the work of the bronchi. It is known that even in the absence of symptoms, bronchial asthma can be manifested by the development of an inflammatory process that occursin the bronchi. You can cope with the disease by adhering to the treatment regimen chosen by the doctor and taking the necessary medications. As a rule, these are inhalers, which should always be at hand.

Experienced mothers are studying reviews of pregnancy and asthma, how these two conditions of the body can affect the developing fetus. Most of the reviews are positive, and this is due to the fact that the woman is responsible for the doctor's recommendations. Even during periods of remission of the disease, the situation should not be allowed to take its course. In moderate persistent asthma, experts recommend using drugs that have a long-term positive effect. A drug that contains ephedrine is excluded from the list, as it provokes fetal hypoxia and uterine vasoconstriction.

Treatment methods

Wishing not to harm the baby by taking medications, some women flatly refuse the previously prescribed treatment. This is one of the biggest mistakes. Modern asthma treatment regimens during pregnancy allow the use of those medications that will be safe for the he alth of the baby and can alleviate the mother's condition during periods of exacerbation of the disease.

If the patient's pregnancy is confirmed, and bronchial asthma is not bothering yet, it is necessary to make timely adjustments regarding the previously chosen therapy. The treatment regimen for a disease caused by an allergic reaction (for example, rhinitis) consists in the selection of antihistamines. However, experts do notIt is recommended to take drugs that contain iodine as a treatment. Experts say that they can adversely affect the functioning of the thyroid gland in the fetus.

The treatment regimen should be selected depending on the severity of the disease, since each category of drugs is designed for a specific stage of its development. Ideally, therapy should minimize the need for medication. If a woman planned pregnancy in advance, then with a competent approach to treatment throughout the entire period, the number of seizures will be minimal.

Inhalers

Doctors warn that in no case should you choose your own inhalers during pregnancy. Asthma is a specific disease that can be confused with ailments that are similar in symptoms. For example, it can be: cystic fibrosis, lesions of the upper respiratory tract, lung diseases, pulmonary vasculitis, hypopnea or apnea syndrome, fungal infections of the lungs, and others. In medical practice, there are cases when the above diseases are diagnosed together with bronchial asthma. This complicates the process of treatment and the selection of a therapy regimen during pregnancy.

Inhalation allows you to deliver the necessary components directly to the bronchi, while a small amount of active substances enters the bloodstream, which minimizes side effects that may adversely affect the development of the fetus. Experts recommend not to interrupt the treatment regimen and not to change the dosage of the prescribed beforepregnancy drugs. Otherwise, it can lead to stress in the body and an increase in the number of daytime and nighttime attacks.

Inhalers may contain glucocorticosteroids, sodium cromoglycate, theophylline. The main rule: among the components should not contain freon. One of the safest is Symbicort Turbuhaler, it is approved for use during pregnancy. Asthma and other lung diseases are the main indications for its appointment. You can take it on an ongoing basis or to stop sudden attacks, you can not abruptly cancel the drug. It is contraindicated in the initial stage and in episodic treatment. The duration of the course is selected under the supervision of a physician.

Approved drugs

In medical practice, there are two categories of drugs for asthma during pregnancy:

• Bronchodilators - intended for emergency help, relieve an attack, but cannot be used on a permanent basis.
• Drugs that relieve allergic reactions and inflammation are not provided for emergency care. They are taken for a long time, perhaps even several months or years.

When prescribing medications, doctors try to choose those that have minimal side effects and are allowed during pregnancy. If you look at the letter classification, those that belong to group “B” are cromones “Kromoglin” and “Nedocromil”, corticosteroids in the inhaler - “Budesonide”, leukotriene receptor blockers “Montelukast” and “Zafirlukast”. The other popular fast-acting and long-acting beta-agonists, theophyllines, are group "C" (that is, they have not been tested on humans, the study took place only on animals).

It is important to understand that this information is for informational purposes only. A woman should be responsible for her pregnancy with bronchial asthma. Reviews of those who have already become a happy parent, having such a diagnosis in their medical history, recommend leukotriene antagonists. Despite the availability in terms of acquisition, only a doctor can prescribe them. It is not recommended to change drugs on your own during pregnancy, even if there is information about their safety.

Prevention measures

Any disease is easier to prevent than to cure. This also applies to asthma during pregnancy at any stage of its development. The easiest option is to avoid allergens, after which the woman has asthma attacks, cough, shortness of breath. It is advisable to keep order and cleanliness in the house, since dust can also become an asthma provocateur. A favorable environment at home, the absence of stress and worries are also preventive measures.

If a pregnant woman has a tendency to seasonal allergies (for example, in the spring during the flowering of trees and flowers), experts do not recommend planning the start of pregnancy at this time. The optimal period for conception can be selected together with the attending physician, who, adequately assessing the state of a woman's he alth, will be able to offer the most successful period for starting active actions.

The same goes for the situationwhen the patient has frequent respiratory problems. It is important to take timely measures to prevent nasal congestion, the formation of edema. This can be achieved by taking vitamins and dietary supplements that stimulate the immune system. This will avoid the negative impact on the fetus of asthma during pregnancy.

If an oxygen deficiency is established during the diagnosis of the he alth of the fetus, the specialist may recommend or prescribe oxygen therapy. It is also important to stay physically active and spend more time outdoors. It is desirable that there are as few allergens around as possible, especially plants and trees that can provoke an allergic attack.

Expert Opinion

The negative impact on the fetus of bronchial asthma during pregnancy can be reduced to a minimum by adhering to the recommendations of specialists. They unanimously claim that there is only one way to harm the baby - by refusing any previously prescribed treatment. Children born as a result of the mother taking drugs during pregnancy, which are prescribed to reduce asthma attacks, are no different (in terms of he alth) from other children. We can safely say that bronchial asthma and pregnancy are quite compatible and manageable for all nine months.

Doctors recommend having a special portable device on hand at home - a peak flow meter that allows you to assess lung function without visiting a doctor's office.

The device has a special multi-colored scale, which, when exhaled into a special tube, shows the performance of the lungs. In addition to assessing the state of the work of the bronchi and understanding the overall picture of the disease at the moment, the data obtained are necessary for analysis. During the next visit to the doctor, it is desirable to have the results of home measurements. Thus, the specialist will be able to diagnose changes in the body of a pregnant woman in time.

It is possible to assess the well-being of the fetus not only during ultrasound diagnostics or a scheduled examination by a gynecologist, but also by measuring the number of movements during the day. As a rule, such a diagnosis is carried out after the 28th week of pregnancy. It is also advisable to pay attention to how the fetus reacts during the next attack. A woman should be wary if the number of movements becomes noticeably less. There is a possibility that at this moment the child receives an insufficient amount of oxygen, which can lead to hypoxia. The most frightening moment is when the number of asthma attacks becomes noticeably greater, and the baby's mobility is less. You should not wait for a visit to the doctor, in this case there is a risk of intrauterine death of the fetus. Timely hospitalization allows you to quickly normalize the condition of the mother and child.