Asthma in pregnancy

A potentially serious medical problem that occurs in approximately 8% of pregnant women.

Patients have a higher risk of preeclampsia, preterm birth, infants with low birth weight, preeclampsia, intrauterine growth restriction, infants with congenital malformations, and perinatal death.

Between 1 and 4% of pregnancies are complicated by poorly controlled asthma.

Approximately one-third of women experience worsening of their asthma during pregnancy, another third experience the same severity of asthma, andi in the remaining third the severity improves.

Patients with moderate or severe asthma experience more acute exacerbations with pregnancy.

About 60% of pregnant females with asthma have no change in their asthma during pregnancy, but 40% have worsening of the symptoms and no individuals improve in their asthma.

Approximately 10% of pregnant women with asthma have an exacerbation during labor.

Diagnosis of asthma doing pregnancy is complicated by symptoms of asthma, notably, dyspnea of pregnancy.

The processes can be distinguished by a lack of cough, wheezing, and airflow obstruction with dyspnea of pregnancy.

Spirometry can demonstrate a bronchodilator response in helping the diagnosis.

Chest x-rays generally or not beneficial in this  setting, unless alternative causes of respiratory symptoms are suggested.

Pulmonary embolism may need to be ruled out.

Fraction of exhaled nitrogen oxide (FeNO) is a marker of eosinophilic airway inflammation and can be used to monitor asthma in pregnant patients.

The pharmacologic treatment of asthma during pregnancy is similar to the management of non-pregnant asthmatic patients: either as needed low-dose, inhaled corticosteroid formoterol, or short acting beta-2 agonist with inhaled corticosteroid.

Approximately 5.8% of patients are hospitalized for asthma exacerbations during pregnancy: medication nonadherence, obesity, African-American race, and viral infections are risk factors.

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