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12 June 2007, 12:40
Asthma in Pregnancy and Breastfeeding.
There are some cases in which asthma can turn life threatening. These patients experience a situation called acute respiratory failure. In this condition the bronchial tubes are completely blocked. The lungs in this condition are devoid of life sustaining oxygen and they also cannot get rid of the toxic carbon dioxide. In such severe condition the machines called ventilators are used to take up the function of respiration.
Asthma is perhaps one of the most common disorders that can develop during pregnancy. It is also one of the most serious disorders that can develop during pregnancy. Since it is state where the hampering of the most vital process of respiration is concerned it should never be neglected and adequate measures should be taken to relieve the situation.
There is no evidence that suggests any increase in incidents of spontaneous abortions or development of congenital deformities in pregnant ladies with asthmatic condition.
The respiratory muscles are deliberately paralysed in this process and the ventilator takes up the control of respiration. This process is called assisted ventilation and it can safely be continued for two or three days. When the patient starts to improve, the machine is gradually turned down and the person is weaned away from the machine.
Generally the available statistics show that the asthmatic ladies who get pregnant have worsening of their disease in about one-third of the cases. Anther one-third patients show no changes in their conditions and the last one-third show signs of getting better. It is a very rare incident that an asthma patient has complications due to her condition while child birth.
This process is available in bigger hospitals and has very low mortality rate. Along with a lot of anti-inflammatory drugs are given with intervention properties. This makes relapses rare and there is very little scope of the asthma patient developing this condition again very soon. This is all thanks to the fast moving growth and constant changes that have happened in the field of medicine and health care. So many incidences prove beyond doubt that if the patient gets medical attention in time he or she is sure to be saved and may even have chances of not having a repeat of same condition for a long time.
In most situations ladies come back to their normal condition of the disease within three to four months of delivery. This may be indicative of nature’s way of supporting the sustenance of the human life. Some studies have an indication that asthma occurs in one percent of all pregnancies. Some studies also indicate that asthmatics may have a greater chance of giving birth to premature children or even run the risk of malformed infants or even infants with low birth weight.
It is generally seen that the asthmatic ladies have greater fear of showing signs of any untoward complications during pregnancy and delivery.
But many studies point towards a stark reality that most of the deaths from asthma occur at home or on the way to the hospital. The lack of availability of medical attention at the time of death also does not prove anything or point towards any concrete conclusions during the last moments. In such an event it becomes almost next to impossible to derive the exact reason why such episodes of fatality actually occur. Asthma researchers are now concentrating deeply on studying the patients who make it to the hospital and do emerge as survivors after a fatal asthma attack. These near fatal asthma attacks are termed as “sudden asphyxic asthma”.
There was marked increase in delivery of infant of premature birth and infants with low birth weight as a result of this. There are chances of increased bleeding during delivery. But there does not seem to be any concrete evidence of increased incidents of congenital malformations.
The condition of asthma needs to be treated wisely during pregnancy. This is because the condition of asthma causes a decrease in oxygen content in the blood of the mother and in return to the foetus as well. This may well lead to decrease in the growth of the foetus, which may lead to various degrees of malformations also.
After several studies of patients with near fatal attack of asthma it was found that the patients who survived and those who did not had many things in common and some differences too. On the basis of studying the two groups of patients one who survived and one who did not some very clear characteristics appear that help in developing the profile of patients who are at risk of developing near fatal asthma.
The most common occurrence of asthma happens because of the triggers of simple cold or upper respiratory infections in pregnant ladies. It is therefore advisable to avoid situations of coming in contact with people having colds or respiratory infections for ladies who have a history of asthma when they are pregnant. The other pregnant ladies are also advised the same as there is always a risk of catching an infection and also because there are incidents of development of asthma even in the women who have never showed the disease before.
These criteria can be enlisted as:
• The patients show a history of seizures along with asthma.
• There may be done a recent change in drug treatment or administration dosages.
• There may be wheezing and other symptoms that may be neglected constantly.
• Even at the time when the patient may be discharged from the hospital after treatment from near fatal attack he may be having some wheezing.
• There may be lack of self care at the hospital.
• There may be emotional conflicts between patient, hospital staff and other family members.
• There may be a tendency in the patient to use their asthmatic condition as a tool for emotional manipulation of others.
• Severely dysfunctional family situations.
• Symptoms of mild to chronic depression...
The drugs that are generally considered to be safe can be used to manage asthma during pregnancy. Most of the cases of deformities due to asthma arise because of improper management of asthma during pregnancy. Uncontrolled asthma increases the risk of acute respiratory failure which may put the life of both the mother and the child at risk.
Allergy tests are not recommended to be done during pregnancy. Although the allergy shots are considered to be safe to continue during pregnancy, the allergists or asthma specialists however do not recommend starting of allergy injections during pregnancy. The drugs should also not be self-administered without the doctor’s prescription and constant monitoring. This is true with administration of other asthma drugs even the ones which are considered to be safe for different kinds of patients.
If the delivery has to be done with the help of a caesarean section the asthmatic mother needs to be monitored very closely. This is because the asthma patients undergoing surgery that requires anaesthesia have to be closely monitored especially the surgeries requiring general anaesthesia. All the specialists involved in the surgery should be very well aware of the asthma condition of the patient. There should be done all check ups and breathing tests before the surgery. For the patients of acute asthma it is advisable to select a hospital where respiratory care unit is available.
The mothers who are asthmatic also need to be careful while breastfeeding their child. Mothers who have allergic asthma should definitely breastfeed their child because statistics show that the children who are breastfed show lesser signs of developing allergies like eczema or allergic asthma in younger stages. The drugs taken by the asthmatic mother for her condition have to be carefully monitored because ten percent of the drugs taken by the mothers end up in the breastfed babies and are ingested in them. Some drugs may be more harmful than the others. Let the decision of which drugs to be taken be the prerogative of a competent doctor.
Pregnancy, childbirth and nursing the child are beautiful situations of a woman’s life. It is therefore very important to be take ample care so that any effect of the mother’s diseased condition should never reflect upon the child.
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