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Asthma care during pregnancy and surgery

  • Pregnancy

    Maintaining asthma control during pregnancy is important for the health and well-being of both the mother and her baby. Maintaining lung function is important to ensure oxygen supply to the fetus. Uncontrolled asthma increases the risk of perinatal mortality, preeclampsia, preterm birth and low-birth-weight infants. It is safer for pregnant women to be treated with asthma medications than to have asthma symptoms and exacerbations.

    Monitor the level of asthma control and lung function during prenatal visits. The course of asthma improves in one-third of women and worsens for one-third of women during pregnancy. Monthly evaluations of asthma will allow the opportunity to step up therapy if necessary and to step down therapy if possible.

    pregnancy with asthma

    pregnancy with asthma

    Surgery

    Patients who have asthma are at risk for complications during and after surgery. These complications include acute bronchoconstriction triggered by intubation, hypoxemia and possible hypercapnia, impaired effectiveness of cough, atelectasis and respiratory infection and if a history of sensitivity is present, reactions to latex exposure or some anesthetic agents.

    The following actions are recommended to reduce the risk of complications during surgery:

    • Before surgery, review the level of asthma control, medication use (especially oral systemic corticosteroids within the past 6 months and pulmonary function.
    • Provide medications before surgery to improve lung function if lung function is not well controlled. A short course of oral systemic corti-costeroids may be necessary.
    • For patients receiving oral systemic corticosteroids during the 6 months prior to surgery and for selected patients on long-term high-dose ICS, give 100 mg hydrocortisone every 8 hours intravenously during the surgical period and reduce the dose rapidly within 24 hours after surgery.

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