| Maternal asthma that is preexisting will not change in frequency of exacerbations, but the mother may tolerate the exacerbations less because of the normal physiologic changes of pregnancy. Severe cases of maternal asthma are associated with spontaneous abortion, intrauterine fetal demise, intrauterine growth restriction, and preeclampsia. Cleft palate is thought to be a complication of oral corticosteroid use during pregnancy.
Treatment of asthma during pregnancy includes short-acting beta-agonists, including albuterol, as needed in mild and intermittent asthma, and also as needed, for more severe disease. For mild persistent asthma, an inhaled corticosteroid at a low-dose should be added to the pharmacologic regimen, and a medium-dosage inhaled corticosteroid, or a low-dose inhaled corticosteroid PLUS a long acting beta-agonist, like salmeterol, are used in cases of moderate persistent asthma, and a high-dose inhaled corticosteroid with a long acting Beta-agonist are indicated in cases of severe persistent asthma. [7] |