Should asthma inhalers be used during pregnancy?

The article was written by a pharmacist working at the Pharmacy Department - Vinmec Ha Long International General Hospital.

Many people are concerned about the unwanted effects that may be experienced for the mother and fetus when using asthma medicines. However, the benefits from taking asthma control medications slightly outweigh those from not using them.

Asthma (bronchial asthma, asthma) is a chronic disease of the bronchi in the respiratory tract, in which inflammation causes the airways to tighten, leading to restriction of the amount of air in and out, and at the same time. cause other symptoms. According to statistics, 3% to 8% of pregnant women have asthma.
For women with asthma:
Before becoming pregnant, talk to your doctor about your condition. If you find out you are pregnant, you should continue to take your asthma medication and see your doctor as soon as possible to get the right advice. Stopping your asthma medication suddenly can harm you and your unborn baby. Many women worry about how the body changes during pregnancy can affect their asthma and, if treated, could harm the unborn baby. In fact, there is a small increase in the risk of one or more of the following pregnancy complications among women with asthma compared with women without asthma:
Gestational hypertension or preeclampsia Preterm birth Having a C-section The baby is born with a lower birth weight However, with the right approach to asthma control, most women with asthma go through a normal pregnancy and give birth to a healthy baby.

The severity of asthma during pregnancy is not the same among pregnant women. It is difficult to predict the course of asthma during a woman's first pregnancy. The severity of asthma in the first pregnancy was similar in subsequent pregnancies.
Statistics show that asthma worsened in 1/3 of women, improved in 1/3 of women and remained stable in the other group:
With the group in which asthma worsened During pregnancy, asthma usually gets worse between 29 and 36 weeks of pregnancy. For the group whose asthma improved during pregnancy, the improvement was gradual throughout the pregnancy. In addition, asthma is less severe in the last month of pregnancy and labor does not worsen asthma.

Here are some simple measures that can help control environmental factors that worsen asthma and prevent asthma attacks:
Avoid exposure to allergens that lead to asthma of the patient, especially pet dander, dust, pollen, cigarette smoke, perfume, etc. Smoking is not recommended or allowed in the house. Regular flu vaccination (1 year/time) is recommended. even while pregnant.

The top two goals of asthma control in women during pregnancy are:
(1) Preventing acute attacks
(2) Optimizing asthma control
Asthma medications are divided into different categories according to the group of pharmacological effects, the purpose of use (acute asthma or long-term asthma control), dosage form.
The use of inhaled (locally acting) inhalers is considered safer for the fetus than systemic drugs. Drug manufacturers often combine an inhaled bronchodilator and an inhaled glucocorticoid to enhance asthma control. Here are some common asthma medications that can be used by pregnant women:

Evohaler/Accuhaler/Turbuhaler are drug delivery devices, each with a different use. Therefore, in order to achieve a therapeutic effect, the patient needs to carefully read the instructions for use of the instrument in the drug user manual/consultation of medical staff. like in the lungs. The patient may not taste or feel the drug after inhalation. Rinse mouth after inhalation to reduce the risk of oropharyngeal fungal infection. Clean equipment according to manufacturer's instructions. to the level of the disease. Use the drug exactly as prescribed by the doctor, do not arbitrarily choose, reduce the dose or stop the drug. Medications for long-term asthma control need to be taken regularly for optimal benefit, even in the absence of symptoms.

In order to effectively treat asthma during pregnancy, pregnant women need to have regular health checks and comply with the treatment.
During pregnancy, the mother always needs to monitor the health of herself and the fetus through adequate antenatal check-ups and a balanced diet and lifestyle. In the use of medicinal preparations, the mother's body is sick, it is necessary to have advice and examination from an obstetrician-specialist to avoid bad effects from diseases as well as medicinal products. pregnancy. When any signs of complications occur, pregnant women need to be taken to the hospital for early examination and treatment to minimize unnecessary consequences.

The article references the source: Vinmec 2019 manual of medicine, Uptodate.com