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Asthma and pregnancy: interactions and management

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Asthma is one of the most common diseases complicating pregnancy. It can lead to significant morbidity for both mother and foetus. Pregnancy may also affect asthma control and severity. Therefore, pregnant asthmatic patients should receive integrated obstetric and respiratory care. The focus of asthma treatment remains the control of symptoms and maintenance of normal lung function of the mother. However, during pregnancy, the safe delivery of a healthy baby is an additional goal. It is safer for pregnant women with asthma to be treated with asthma medications than for them to have asthma symptoms and exacerbations. Asthma treatment during pregnancy follows the same step-wise approach as normal, and studies have shown that first-line asthma medications (such as inhaled glucocortico-steroids and beta(2)-agonists) are not associated with an increased incidence of foetal abnormalities. Moreover, inhaled glucocorticosteroids have been shown to prevent exacerbations of asthma in pregnancy and should be used in persistent asthma to control the disease and prevent exacerbations. If acute exacerbations develop, they should be treated promptly and aggressively in order to avoid foetal hypoxia. Good pregnancy and asthma outcomes are achieved through integrated obstetric and respiratory care, close monitoring, meticulous tailoring of pharmacotherapy, patient education and reassurance. This review describes interactions between asthma and pregnancy and briefly presents treatment guidelines.

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