Bronchial Asthma during Pregnancy and Breastfeeding
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Physiological changes occurring during pregnancy can cause both worsening and improvement in the asthma course. Pregnancy can act as an independent factor in the onset of asthma. Pregnancy can affect the course of asthma, and asthma itself can affect pregnancy.
Basic principles for the treatment of pregnant and lactating mothers:
- control of asthma is significant during pregnancy for both the mother and the baby, reducing the risk of possible complications;
- an important part of managing a moderate to severe asthma in a pregnant woman to maintain good control is to follow the doctors’ recommendations;
- it is important that women who smoke know that it is dangerous both for the woman herself and her child, and it is necessary to help in refusing to smoke.
Drug therapy in pregnant and lactating women:
- The use of bronchodilators or their combinations is prescribed according to usual indications during pregnancy or breastfeeding.
- The administration of inhaled glucocorticoids is also carried out according to the ordinary indication, in accordance with the step therapy of asthma treatment.
- Treatment of asthma exacerbation in pregnant women is carried out in the same way as in non-pregnant according to treatment standards, including systemic steroids.
When a severe exacerbation of bronchial asthma is recommended monitoring of the fetus. For women with poor bronchial asthma control, contact between a pulmonologist and an obstetrician is necessary for the early transfer of a woman with severe exacerbation of asthma to the intensive care unit.
Treatment of asthma during labor:
- an asthma attack rarely develops in childbirth;
- it is necessary to continue taking anti-asthmatic drugs during childbirth;
- if anesthesia is indicated as pregnant, a local blockade is more preferable than general anesthesia;
- in the absence of an exacerbation cesarean section is carried out according to usual obstetric indications;
- Therapy of asthma in breastfeeding women: asthma is not a contraindication for breastfeeding.
Basic anti-asthmatic therapy is carried out as usual.