ACOG Releases Asthma Guidelines in Pregnancy

Diagnosis, evaluation and medical management guidelines based on best available evidence

FRIDAY, Feb. 1 (HealthDay News) -- The American College of Obstetricians and Gynecologists (ACOG) recommends treatment of asthmatic patients during pregnancy with medications, depending upon the severity of the condition. This information is included in an ACOG Practice Bulletin published in Obstetrics & Gynecology in February.

The ACOG Committee on Practice Bulletins devised these recommendations because 4 percent to 8 percent of pregnant women have asthma. The recommendations are based upon the best available evidence. They suggest that standard methods of diagnosis be used to diagnose asthma in a pregnant patient, and that pregnant women with persistent asthma should undergo routine pulmonary function evaluation tests.

Asthma in pregnancy should be treated in a stepwise fashion, according to the committee's recommendations. Medications, such as albuterol, inhaled corticosteroids, cromolyn, leukotriene receptor antagonist, theophylline, or inhaled corticosteroids and salmeterol should be prescribed, depending upon the severity of the patient's disease. Medications should be continued through labor and delivery, and patients should be advised to avoid irritants, such as tobacco smoke. As asthma medications are secreted into breast milk in only small concentrations, drugs such as prednisone, theophylline, antihistamines, cromolyn, β2-agonists and inhaled corticosteroids may be taken by women who breast-feed their infants.

The ACOG committee notes that "the gravid patient with mild or moderate asthma can have excellent maternal and infant outcomes. However, suboptimal control of asthma during pregnancy may be associated with increased maternal or fetal risk."

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