Bronchial Asthma And Pregnancy
December 11th, 2008 -- Posted in Feeding, Reproductive Disfunction | Comments Off
Bronchial asthma is one of the most common lung diseases in pregnant women. During pregnancy there may occur different forms and stages of bronchial asthma. Bronchial asthma usually begins before pregnancy, but it may first appear or develop during encyesis.
Those pregnant women, who had asthma attacks prior to gravidity, may suffer from attacks of asphyxia both in early pregnancy and in the midpregnancy. Asthma, arose in early pregnancy, similar to early toxicosis, may pass over by the end of its first half. In these cases, the prognosis for the mother and the fetus is usually quite favorable.
Bronchial asthma that began before gravidity may have different development. The asthmatic women while progressive pregnancy may have pathological changes in the immune system, which have negative impact both on the course of the disease, and on pregnancy.
The run of asthma is usually impairs in the first trimester of pregnancy. In the second half of pregnancy the disease runs easier. If deterioration or improvement emerged in the previous pregnancy, it can be expected in the next one.
The expectant mothers down with asthma are more likely to have an early developed toxicosis (37% of pregnant women), threatened miscarriage (36%), violations of pregnancy course (19%), fast and rapid delivery (metrypercinesia), resulting in a high rate of birth injuries (23%). That means that dysmature infants and low-birth-weight children can be born. Pregnant women with severe asthma run high risk to experience spontaneous miscarriage, premature birth and cesarean operation. Cases of death of the fetus before or during birth occur only during severe disease and inadequate treatment of status asthmaticus.
The patients down with bronchial asthma at the full-term pregnancy generally give birth through natural delivery path, as the attacks of suffocation at birth can be prevented. Frequent attacks of suffocation, and asthmatic conditions observed during pregnancy, the ineffectiveness of the treatment serves as the indication for early delivery at 37-th or 38-th week of pregnancy.
Attacks of bronchial asthma during the delivery are rare, especially during prophylactic use of glucocorticoid drugs (prednisolone, hydrocortisone), or bronchodilators (aminophylline, ephedrine).
After giving birth the running of asthma is improved in 25% of women (the patients with mild disease). Fifty percent of women experience no changes in status asthmaticus, 25% of asthmatic expectant mothers suffer from deterioration of the disease and they have to take prednisolone, with the dose to be increased.
The disease of the mother can affect the child’s health. Five per cent of children develop asthma during the first year of life, 58% are down with the disease in subsequent years. Newborn infants during the first year of life often have diseases of upper air passages.