Astma in nosečnost!

Question:

I am 25 years old and would love to get pregnant in the near future. I have been battling asthma since childhood. I am taking medication with a glucocorticoid, when Ventolin gets worse. Even with a little effort, my lungs wheeze, so the possible abandonment of medication due to pregnancy would not be the right solution. Two years ago, I temporarily stopped taking medication because I felt I was fine and experienced a severe worsening of my asthma. At the examination, the specialist told me that I can take medication without any problems, because it is worse for the fetus if it does not have enough oxygen than the sprays I use, because they remain on the mucous membrane of the lungs and do not penetrate into the blood. Please advise me how to manage asthma and pregnancy?

Answer:

During pregnancy, in 1/3 of patients, asthma progresses normally, in 1/3 it worsens, and in 1/3 it is easier to manage. Either way, you never know in advance which group an individual’s asthma belongs to. Medicines should not be discontinued during pregnancy. The worst thing for the fetus is that the inhalation therapy is discontinued and there is such a deterioration that the mother begins to lack oxygen. The fetus does not have much oxygen reserve, so hypoxia - a drop in oxygen in the blood - can lead to brain damage in the baby. The drug that is the longest of the inhaled glucocorticoids on the market and is the first recommended of inhaled glucocorticoids is budesonide, but pulmonologists insist that the therapy that was previously introduced and works does not change. At the same time, there is insufficient evidence that biological therapy is safe during pregnancy. Pregnancy during treatment with biologics is not recommended or biologics are discontinued beforehand. For now, there are not enough safe recommendations to continue with them.

Doc. dr. Sabina Škrgat, Ph.D. med., specialist in pulmonology and internal medicine

Source: myDOCTOR in Europe, www.mydoctor.si