Many women who suffer from asthma are concerned about how their illness affects their pregnancy. First and foremost, most people worry about permanent damage to the child.
A question of attitude
The good news right away: scientists were able to largely eliminate these concerns. Studies show that asthmatics do not have an increased risk of complications during pregnancy compared to non-asthmatics. However, only if the disease is well adjusted with medication.
No reason to take his illness lightly before or during pregnancy. For what makes otherwise healthy women during the nine months - weight gain, shortness of breath and heartburn, for example - makes this particularly unpleasant for asthma sufferers.
Asthma medication during pregnancy
The basic requirement for a complication-free pregnancy with asthma is an optimal drug setting and the prevention of asthma attacks. For this, all known triggers must be avoided consistently. Badly treated asthma causes a decrease in the oxygen content in the mother's blood. Because even the unborn child is supplied with maternal blood, the oxygen content is also lower here. However, since the fetus needs a constant oxygen level for healthy growth and survival, asthma-related fluctuations in oxygenation can significantly reduce the baby's birth weight.
In numerous studies, the risk of increased malformations after asthma medication could not be proven. This also applies to cortisone, which is still regarded as indispensable by experts in many cases. The risk of uncontrolled asthma is many times higher than the risk of targeted and controlled asthma therapy. However, the drugs are given during pregnancy preferably as aerosols and sprays to avoid the passage of the drug into the bloodstream of the child as much as possible.
Worse or better?
The question of whether the asthma deteriorates or improves even during pregnancy is best answered with "both - and". Extensive studies have shown that the symptoms worsened in 37% of all patients, improved in 29% and remained constant at around 34%. Experience has shown that worsening often occurs at the end of the second trimester and at the beginning of the third trimester. In the last four weeks of pregnancy, however, the situation often improves.
One reason for deterioration in asthma during pregnancy appears to be reflux of gastric acid into the esophagus. This causes heartburn and triggers asthma in some women. An improvement in asthma, however, is attributed to an increased own cortisone production.
Provision is better
During pregnancy, asthmatics not only have to take gynecological check-ups, but also have to consistently control their underlying disease. These include lung function tests at the beginning and, if lung function is limited, at least every four weeks during pregnancy. If the asthma is particularly severe, the intervals should be significantly shorter. The peak flow should be measured and logged daily.
An arterial blood gas analysis is recommended as part of the check-ups in order to recognize early on a possible risk to mother and child. Regular ultrasound examinations throughout the child's pregnancy provide information about the child's growth and development.
Asthma: natural birth or cesarean section?
Basically, asthma does not mean the end of a natural birth. The question of whether the child should be born by caesarean or vaginal, is in this case more of a personal decision than a medical necessity. Even if the illness worsens during pregnancy, the risk of miscarriage or premature birth does not increase. This was the conclusion of a study in which a total of 873 pregnant women with mild asthma, 866 with moderate to severe asthma and 881 without asthma participated. Again, the complication rate was comparable in all three groups. However, women with severe asthma released more often by caesarean section.
An epidural analgesic during a vaginal delivery reduces oxygen consumption and respiratory minute volume, which reduces the risk of seizure. In addition, the birth is simplified by adequate fluid and appropriate pain relief. All medicines that release histamine must be avoided. Even during childbirth the regular medication should be continued. At oxygen saturation below 95%, the mother is given oxygen.
Unarmed mother, healthy child
The goal of all measures is to bring a healthy child into the world and avoid any complications for the mother. Therefore, the regular control of asthma also includes a written therapy plan that shows how the medication can be changed in the event of an emergency and what measures can be taken in the event of an asthma attack. The emergency measures that were already in effect before the pregnancy are now particularly valid. Patients should always consult a doctor or hospital immediately if
- the treatment does not work at all,
- the treatment only briefly stops,
- the symptoms increase,
- the child moves less than usual or not at all.
So that mother and child stay healthy, constant research is carried out. Among the latest findings is that allergy sufferers obviously can get pregnant easier than healthy women. The reason for this lies in a changed ratio of certain immune cells to each other. This simplifies embryo implantation in the uterus - even in women with asthma.