Pregnancy and Asthma

[yaf_user681_26872]

Hi all,

I know I don't post very often but I do read the boards regually.

I was wondering how many of you out there ran into problems during your pregnancy? My first pregnancy with my daughter was ended early at almost 36 weeks by emergancy c-section as i'd been in hospital for a while and had reached the point that my low sats even on O2 and being on maximum meds started to cause her distress she is absolutely fine i'd been having the steroid injections to mature her lungs so she didn't even go to special care.

I am now 20 weeks pregnant again and have just run into difficulties and was wondering if there is anyone else out there who is or has been in the same boat. My cons said a 3rd of asthmatics get better in pregnancy a 3rd get worse and a 3rd stay the same - why do i have to fall into the get worse trust me!

I have severe/brittle asthma and am steroid dependant.

Look forward to your replies thanks in advance

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Hi Charlotte, I havent been in the same boat but am currently seeing an obstetrician for advice to find out whether it would be safe for me to get pregnant. I have brittle asthma, though it has been better recently and a bit more under control. The obstetrician says it can be done safely but that I should be prepared for lots of monitoring and may need to have the baby delivered early if my chest cant cope towards the end. I am kind of looking forward to it, but at the same time dreading it as I know things will be really difficult. It has helped knowing that you have managed to have a healthy baby as i dont know anyone else in this situation so am not really sure what to expect if I do become pregnant at some point in the future.

Hope things go well for you and that the pregnancy continues healthily

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Hi

I have had asthma practically all my life. I felt on top of the world whilst I was pregnant, full of energy and no breathing problems, it was absolutely fantastic! Fell back into normal routine afterwards though. I think with my next hormonal overdose the menopause - things got worse, although doctors are not convinced that the menopause affects asthma. I'm sure it does.

Best of luck

Carla

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Carla - in broad terms you stop producing female hormones during the menopause, so, rather than being a hormone overdose, it's quite the reverse! I'm not aware of any association between asthma and the menopause.

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I don't have any particularly useful comments about pregnancy and asthma, I'm afraid, but I'm sorry that you're having so many problems, Charlotte, and I hope everything goes okay for you. You must be so proud of your daughter to be doing so well after a difficult start. Well done for not letting your asthma stop you from having a family.

Progesterone, one of the female hormones that regulates your cycle and helps to maintain pregnancy, acts by relaxing the smooth muscle of the womb and also of the gut and the airwarys - it therefore has a bronchodilatory effect. It also has anti-inflammatory effects and helps to regulate the immune response. You might expect, then, that your asthma would be better when progesterone levels are high - eg during pregnancy, inbetween ovulation and menstruation, and if on a progesterone-containing contraceptive.

Clearly that's not the whole story, as only a third of women do find that their asthma is improved during pregnancy. There are of course many other things to consider - pregnancy puts a significant strain on your body, with huge increases in cardiac output and respiratory demand, increased circulatory volume and often anaemia. During the later stages of pregnancy there is also the physical effect of the womb pushing up on the diaphragm and reducing the lungs' ability to expand.

There's not much in the literature on onset of asthma at menopause, but ancedotally, it certainly seems to be a factor in my family. Both my grandmother and my mum developed asthma at that time of life. I decided to do things the other way around by developing asthma aged 14, when I went into puberty, and suffered severe premenstrual exacerbations until I was put on the combined oral contraceptive pill continuously. Anyone who has poorly controlled asthma and is a premenopausal female should consider that their cycle might be an influence and try keeping a diary of symptoms and peak flows over the course of several months - you might be surprised to find that there is a link that you hadn't picked up on.

Sorry not to be of more help with the pregnancy question, I am sure others will have more experience

Take care

Em H

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Hello

ive got brittle asthma and have got 3 healthy boys. My asthma improved a little while i was pregnant, i had a few bad attacks and an allergic reaction. But everything was ok in the end. I spent alot of time worrying and wish i could have more relaxed and enjoyable time. Things are never easy when you have brittle asthma and sometimes have to work harder to achieve things.But we get there in the end! Hope all goes well for the rest of your pregnancy.

All the best

Sarah

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I have three children had my first at 36 weeks due to asthma problems and had my twins at 33 weeks due to the same asthma problems although i negotiated every extra day and was in hospital from 29 weeks. My asthma gets much worse when i am pregnant and immediately after birth no idea why to the point where i have been told it is not safe for me to have any more children as it is unlikely i would survive the pregnancy, but i am blessed with 3 healthy girls.

It is really important that your consultant and obs/gynae talk to each other as they may not want to allow the pregnancy to go full term.

I don't know if you are on theophylline? but that can make a newborn a bit jittery and they keep a close eye on them after they are born, mine were all fine.

My threshold for attending A+E also changed after 20 weeks so that i had to go much earlier than i would normally and would have monitoring in A+E evertime i attended with asthma even if i was being kicked like mad just to check everything was ok with bump. It felt like i had moved in at one point but was worth it to have a healthy baby.

Make sure the resp team know when you go into labour and if your lungs are not stable afterwards ask to be looked after in a side room on a medical ward, (baby goes too) as no disrespect to midwives as they are brilliant at their job but they are not all nurses and in my case did not have the knowledge to cope with a sick brittle asthmatic.

All in all despite being quite sick it was a really positive time and i took great pride in showing to twins off to the A+E staff who had picked up the pieces so many times!

Good luck and get your feet up as often as you can.

[yaf_user681_26872]

Hi all thanks so much for your replies - good to know i'm not alone out there. Sorry for slow reply but I was captured last tuesday and admitted narrowly escaping ITU the team came down but luckily just as my gases started to change for the better. So i was on my normal ward luckily in a side room as the nurses know me so well I sometimes get special treatment on all the normal and IV abx as my WBC was up and having temps. My pottasium wouldnt hold so even though on 2 sando K twice a day was also on 40mml potassium drips the ventolin seemed to disolve it quicker while pregnant i've just escaped now off all IVs just nebbing and high steroids to get me through - luckily coping without subcut as i just can't cope with it.

I missed abi so much was so hard. I feel lucky that i've got to 21 weeks without an admission as I didnt with my pregnancy with Abi was in and out alot earlier on.

I hope things get better as have alot further to go yet I'd really like to get to similar time as last time as Abi didn't need to go to special care and that would really be hard.

I am interested in that you went to chest ward with baby? This was my concern so stayed in maternity hospital but as you say midwives dont have the best idea - when really struggling and doing back to back nebs i was told I was overdosing! In my town the maternity hospital and main hospital are different sides of town so gets tricky, but this sounds like a real solution as the last thing you want is to be separated from your newborn!

Thanks again look forward to talking some more