Management of the pregnant asthmatic patient

Asthma is not an uncommon medical problem during pregnancy. Various physiologic alterations of pregnancy may theoretically affect asthma. Fetal oxygenation is affected more by maternal alkalosis than by hypoxemia, both of which can occur during uncontrolled asthma. Clinical studies suggest a variable effect of pregnancy on asthma and increased maternal and fetal morbidity and mortality associated with severe asthma. Most antiasthmatic drugs are safe to use during pregnancy. Medications used during delivery by the obstetrician may affect asthma, and some antiasthmatic medications may alter labor. We review here a rational approach to the management of steroid preparation for delivery in steroid-dependent asthmatic patients. Asthmatic mothers may breast-feed with minimal risk of adverse drug effects on the infant.