Asthma in pregnancy – Dr. Krishna Karthik

Asthma is a condition that causes your airway to tighten and narrow – called a bronchospasm- making it hard to breathe. It is a chronic inflammatory disease of the airways that is characterized by increased responsiveness of the tracheobronchial tree to multiple stimuli.

The disease is episodic , being characterized by acute exacerbations intermingled with symptom free periods, the attacks are mostly short lived lasting for few hours. It is the most common chronic condition in pregnancy with prevalence ranges from 1-4%. Women with mild asthma are unlikely to have problems, but patients with severe asthma are at greater risk of deterioration usually in the last (third) trimester and these patients need more medications compared to mild asthma.

In fact, severe and/or poorly controlled asthma has been associated with numerous adverse perinatal outcomes like-

With good asthma control, one should be able to expect a normal pregnancy.
The goals of asthma treatment during pregnancy are

Preparation before pregnancy for people with asthma

Preconception appointment with pulmonologist if you are known asthmatic is always recommended so you can have symptom free or less symptom happy pregnancy, and get flu shots and other medications like maintenance therapy.You can continue your asthmatic medications and never use any medication which are not prescribed by doctors.(*many drugs are not safe for your young ones). Inform your gynaecologist about your condition in your first visit will make them aware of your condition and can give you safe medications which doesn’t trigger bronchospasm during pregnancy, during labor and during breastfeeding. You should continue your asthma control plan designed by pulmonologist, and should always be in touch with your doctor. Control of asthma during pregnancy.

The best and safest way to keep your asthma in control is avoiding your trigger and irritants:-

Can Asthma get worse during pregnancy?

It is difficulty to guess whether your symptoms gets worse or better but few studies states
that few women get better during pregnancy even there symptoms are worse during normal
time, such women are probably safe from symptoms in future pregnancy. But in few women
asthma gets bad as they get in to second and third trimester and third can worse. However
with good control plan we can overcome this symptoms.

Should I avoid pregnancy if I have asthma?

Asthma is almost never a reason to not to get pregnant, pregnancy can be an exciting time
of one’s life. It is also a time for you to take care of yourself than any other time and make
sure you are managing all your medical condition, and asthma is also one such thing. Under
a good pulmonologist and gynaecologist with proper action plan combined we can control
asthma throughout your pregnancy.

Is it safe to use inhalers during pregnancy?

The most common question during pregnancy is whether one can use inhalers during
pregnancy and answer is a big yes , you can use inhalers during pregnancy which are very
safe and inhaled medications are usually very low doses which exactly required for you
lungs and the action are completely local thus avoiding critical side effects on your rest of the
body. But it is important for you to meet pulmonologist before pregnancy and make a action
plan and always be in contact with your pulmonologist during entire pregnancy and post
pregnancy especially during breastfeeding and making good action plan is a necessary
thing.


Have a safe and symptom free pregnancy. Thank you.


DR KRISHNA KARTHIK

MBBS, MD, Pulmonology

Consultant Interventional Pulmonologist

Department of Sleep Medicine