Pregnancy

Asthma and pregnancy: what recommendations?

Asthme et grossesse : quelles recommandations ?

During pregnancy, pregnant women with asthma should be subject to special monitoring. Risks, precautions, treatment… We take stock with Dr Anne Prud’homme, pulmonologist.

Pregnancy can have an impact on future mom’s asthma and that has consequences for the fetus. This is why it is important that pregnant women are informed of the risks, but also of the procedure to follow for the monitoring and treatment during pregnancy. Dr. Anne Prud’homme, pulmonologist and head of the working group for respiratory health of women of the French-language Pneumology Society (SPLF), advises us on asthma during pregnancy.

At the asthmatic women, we can sometimes see changes, but this is not always the case. “In a third of the cases it gets worse, in another third of the cases it improves, and in the last third it does not change, explains Dr Anne Prud’homme. Furthermore, if there is no systematic pattern, the same evolution tends to occur during the different pregnancies of the same woman. If asthma gets worse during pregnancy, there has a certain risk to get worse during the following “, she specifies.

The specialist stresses that expectant mothers who have asthma must have special pregnancy monitoring. They must notify the practitioner (general practitioner, gynecologist-obstetrician, or midwife) who follows them for 9 months, but also consult their pulmonologist. “During pregnancy, we are very attentive to the evolutionary profile of asthma, because” you have to adapt the treatment if it gets worse or improves “, specifies Anne Prud’homme. She recommends that the women concerned consult their pulmonologist at least twice during pregnancy or, even better, to see it once every quarter: “The goal is to have controlled asthma”.

“It is essential to continue treatment when you are pregnant “, says the specialist. An asthma attack can have serious consequences for pregnancy and the fetus. Besides, unlike others, these drugs are not dangerous for the mom and her unborn baby. “The pictograms on the asthma medicine boxes can have serious consequences as they may cause treatment to be stopped. My fellow pulmonologists and toxicologists do all the work to signal that they are not dangerous. Their presence complicates things a lot because, on seeing them, pregnant women are afraid of the possible consequences for their baby and do not take their treatment. However, if they are not treated, it can have effects harmful about their future child. You have to go beyond that by saying: ‘I take care to protect my baby’ “, underlines Anne Prud’homme. According to the pulmonologist, the world medical literature shows that there is no danger during pregnancy with these drugs, and that it is the fact of not taking them that will entail a risk. “You should know that the benefit of treatment is very much greater than not treating yourselfr. So that expectant mothers can learn and be reassured, she advises them to go to the websites of the French-language pulmonology society and Reference Center for Teratogens.

During an asthma attack, or acute asthma, the oxygen level in the blood changes. “Even during a small crisis, it is enough that the oxygen level drops a little in the mother so that it drops a lot for the fetus”, says Dr Anne Prud’homme. Gold, asthma attack in pregnant women is not without risk. “This has consequences for the course and duration of pregnancy. This lack of oxygen creates complications, such as low birth weight, premature births, and even miscarriages during very serious crises.”

In case of acute asthma during pregnancy, you must react as if the person was not pregnant, says the specialist. “The treatment is the same. inhale your bronchodilator to open the bronchi. If it doesn’t work, take the cortisone and call 15 or 18 “, explains the pulmonologist.

For pregnancy to go well in women with asthma, there are a few recommendations you should follow. “In all asthmatics and all pregnant women, and therefore even more so for future asthmatic mothers, it is recommended to get the flu vaccine “, advises Anne Prud’homme. Furthermore, even more than for other expectant mothers, active or passive smoking should be banned. The pulmonologist warns pregnant women. “Smoking is horror. Smoking is independent of asthma, but it makes the situation worse because tobacco, in addition to being toxic to women and the fetus, considerably reduces the action drugs against this pathology. As the treatments are inhaled, we breathe the products, and if we smoke, the action is reduced by half. We are therefore completely wrong if we smoke, that we are pregnant and that we are asthmatic . Finally, as with all other expectant mothers, it is advisable to exercise adapted. “You have to do sports that promote endurance. In pregnant women, it will essentially be walking and swimming”, recommends the specialist.

If asthma is stable, there is no over-risk of crisis during childbirth, reassures Dr. Anne Prud’homme.“You must warn the medical team, take the medication before work, even if you have chosen to do an epidural or other anesthesia to limit the pain. The effort may trigger a little discomfort, but the use of bronchodilators works very well”, explains the specialist.

After birth, it is recommended to return to your pulmonologist. Indeed, “the bronchial structures and asthma return to the way they were before about two months after childbirth”, specifies Anne Prud’homme. This is why she advises to make an appointment in the two or three months following the birth of the baby, to readjust the treatment.

For more information, pregnant women who have asthma can obtain information from the Asthma & Allergies association, which supports and informs asthmatic or allergic patients, but also health professionals. For this, they can contact the toll free number Asthma & Allergies Info Service (0800 19 20 21), or go to www.asthme-allergies.org.

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