Abstract
Asthma is one of the most common diseases complicating pregnancy. Uncontrolled asthma
can produce serious maternal and fetal complications; prompt initiation of effective
treatment, both pharmacologic and nonpharmacologic, is critical. With attentive and
appropriate management most asthmatics can anticipate a pregnancy outcome similar
to an average uncomplicated pregnancy. In patients with severe asthma there remains
a higher incidence of preterm delivery and low infant birth weights. The physiologic
changes of pregnancy do not alter spirometry and peak expiratory flow rates, which
can be employed to monitor the severity of asthma during pregnancy. Early fetal monitoring
with sonography provides a benchmark for progressive fetal growth. Sequential sonographic
evaluations are indicated if asthma is moderate or severe or if growth retardation
is suspected. Patients with anything more than mild occasional asthma should be treated
with anti-inflammatory agents (inhaled steroids or cromolyn/nedocromil). Long-acting
beta-2 agonists and/or theophylline can then be added. Only 10% of women with asthma
have an exacerbation during labor. Patients receiving recent oral corticosteroids
should receive stress dose steroids during labor and for 24 hours postpartum.
Key Words:
asthma - pregnancy - pharmacotherapy
