Asthma Issues during Pregnancy: Labor and Breast Feeding

Labor

A pregnant woman should know and take into consideration, that at bronchial asthma in comparison with healthy women the risk of both premature labor and postterm pregnancy is increased, which requires careful gynecologist monitoring. To avoid asthma exacerbation basic therapy is not canceled during labor. It is necessary to register peakflowmetry indicators from labor beginning and than at least every 12 hours. If pregnant woman has previously received systemic hormonal drugs, systemic hormones are applied during labor to prevent adrenal insufficiency. It is known that adequate analgesia during labor reduces bronchial asthma exacerbation risk.

Labor coarse at women with asthma is different, according to statistics in most cases there is a need for labor induction and caesarean section (in this case, peridural anesthesia is preferred). For labor induction it is possible to apply oxytocin, but prostaglandin and ergonovine drugs are conterindicated.A number of drugs used for anesthesia and analgesia (morphine, thiopental, etc.) are also conterindicated because of their ability to depress inspiratory center or cause histamine release and provoke bronchismus.

Risk of Having a Child with Asthma and Allergies

Every woman is concerned about her unborn child’s health, and since inherited factors definitely participate in bronchial asthma development, this point should be reviewed in particular. Question of atopy inheritance (hereditary tendency of the body to respond to environmental influences by generation of excessive amounts of immunoglobulin E) is studied more accurately. It should be noted, that it is not essential bronchial asthma hereditary transmission, but risk of allergic disease development in general; it is risk rather than fatal inevitability.

Atopic diseases include allergic rhinitis and conjunctivitis, atopic dermatitis, acute urticaria and atopic asthma. Of course, atopy risk for the child from family, all members of which are for generation suffer from atopic diseases, is higher than in families that never had these diseases. The greatest risk is registered in families with hereditary from both parents. The risk to inherit atopy from mother is higher than father, but a child with atopy may be born in family with no allergies. Allergic diseases are not a reason to avoid pregnancy.

Allergy is a widespread disease in the modern world, and up to 40% of people at least once in their life experience any of the symptoms. But allergic diseases development, in addition to heredity, is influenced by other factors, including:

  • house microecology;
  • smoking parents;
  • child’s feeding, etc.

pregnancy
Active and passive smoking and environmental pollution are no less important than family history. Dietary factors (both diet during pregnancy and breastfeeding, and presence or absence of breastfeeding), living conditions, even number of children in the family, as well as allergens effect (external and internal – house dust mites, microscopic molds, allergens of pets, rodents and cockroaches) play a significant role. Hypersensitivity to allergens development and allergic disease formation risk should be regarded to not as a sentence, but only as a basis for carrying out necessary measures. But if there is a necessity to protect yourself, your home and your future child from tobacco smoke influence, in order to properly plan other measures you need to know more about your body. In case of bad family history it is recommended to protect a child from allergens from birth, as well as in case of excessive amounts of general immunoglobulin E in the blood taken from umbilical cord during labor (this analysis is carried out in case of bad family history). Several studies have observed reduced risk of allergic diseases at early and prevention prescription of probiotics that contain certain types of lactic bacteria (http://textbookofbacteriology.net/lactics.html).

Breast Feeding

There are a lot of special and popular literature about breast feeding benefits, so there is no need to observe this point in details. It is recommended to breast-feed until at least 6-month-old, and a woman herself must keep to hypoallergenic diet. Adding complementary food choose products with low allergenic capacity.

The video is described 10 benefits of breast feeding:

Pregnant women with asthma should also get specialist’s recommendations on drugs use during breast feeding. If drugs administration is necessary, they are applied not later than 4 hours before feeding, in this case their concentration in breast milk is minimal. Some amount of most drugs get into beast milk and their possible impact must be taken into account. A number of drugs that can be prescribed to breast-feeding women, it is recommended to stop feeding during treatment. However, safety indicators during pregnancy and breast feeding are not always the same. For example, antibiotics-macrolides (e.g. erythromycin) which can be prescribed during pregnancy can’t be applied during breast feeding, since their concentration in breast milk is 2-4 times higher than concentration in blood plasma. Theophylline in breast milk can cause at child toxic effects, irritability, tachycardia and arrhythmia. All antihistamine drugs in small amount get into breast milk. It is not established whether inhaled hormones come into breast milk, although it can be assumed that local inhaled drugs get into breast milk in small amounts with minimal systemic effect when applied at recommended dosage.

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