| April 2006 · Vol. 18, No. 4 OBSTETRIC EMERGENCIES
Safe, efficient management of acute asthma
Fear that drugs will harm the fetus is the biggest barrier to control, but uncontrolled asthma is more dangerous
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Fast Track
Good control of asthma means oral steroids can be avoided
Do not start immunotherapy during pregnancy. If it is underway at conception, it can be continued and maintained at the same dosage
Budesonide is a good choice for high-dose inhaled steroid and is now a category B drug
At the first visit, reassure the patient that it is safer to control her asthma with drugs than to stop therapy
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Joan
C.
Gluck,
MDPresident, Florida Center for Allergy and Asthma Care, Miami Paul
A.
Gluck,
MDClinical Associate Professor of Obstetrics and Gynecology, University of Miami
CASE Could fetal loss have been prevented?
“L.S.” is a 23-year-old gravida at 16 weeks’ gestation who is experiencing severe asthma. Prior to pregnancy, her asthma was moderate and persistent, but was well-controlled on a low-dose inhaled corticosteroid accompanied by monthly use of a short-acting beta-2 adrenergic inhaler and weekly allergy injections. When she learned she was pregnant, L.S. stopped all treatment except for the beta-2 adrenergic inhaler, which she now uses daily.
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