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How can I control asthma during pregnancy?

Dr Irwin Ziment
Professor of Medicine,
University of California, Los Angeles (UCLA), USA

Q: I have some major complications. I am an asthmatic, and an alcoholic as well (I started drinking to help myself sleep with my asthma, but over the years I have been drinking almost 5 days a week, 2-3 pegs of rum. I have had two MTPs, immediately after marriage 5 years ago within a gap of a single year. Now I am afraid - I am pregnant again. I have missed my period and I am experiencing breast tenderness, etc. My asthma symptoms are showing no signs of waning so I have been on bronchodilators and inhalers (both steroid and asthalin). I think I felt my symptoms only two - three days back and have been drinking only a couple of days ago. Dare I go ahead with the child? What are the risks of a third MTP?

A:Asthma during pregnancy often undergoes improvement, and thus the problem should not present any additional worries. Aerosol drugs that are used to control asthma are safe to use during pregnancy, but excessive use of fast-acting bronchodilators for acute episodes should be avoided, if possible. For severe attacks, steroids can be given by mouth or intravenously, since they do not harm the foetus. Oral drugs and alcohol should be avoided as much as possible, especially during the first 3 months of pregnancy when the foetus is most vulnerable to harm. Medical termination of pregnancy should not alter the severity of the asthma or the treatment that is required for the asthma. Thus this issue does not matter as far as asthma management is concerned.