Expecting a baby is an important and desired event inlife of every woman. During pregnancy, maintaining one's own health should be the main goal of the expectant mother, since this is the time when the basic foundations of the baby's health are laid. Even 20 years ago, bronchial asthma and pregnancy were incompatible. But today, leading experts are unanimous in their opinion: this disease is not a contraindication for pregnancy. Bronchial asthma is a common lung disease in pregnant women, which can manifest itself even before pregnancy or during the first trimester. The main thing is not to refuse medications and not to stop treatment throughout all nine months. If you follow all the recommendations of your doctor, there will certainly be no complications.

Treatment of bronchial asthma

When planning a pregnancy, a woman who knows about herзаболевании, должна проконсультироваться у своего врача, какие лекарственные препараты можно принимать в период беременности, а какие нельзя, приобрести тонометр, чтобы всегда следить за состоянием своего артериального давления. Врачи отмечают, что у женщин с бронхиальной астмой гораздо чаще повышается давление, даже если до беременности они с этим явлением никогда не сталкивались. В случаях обострения заболевания необходимо немедленно обратиться к врачу. Многие женщины пренебрегают советами специалистов, так как не доверяют современным методам лечения. И очень зря — в подобной ситуации самолечение может нанести непоправимый вред. Причем не только будущей маме, но и ее малышу. Существуют множество мифов о лечении астмы, ведь не так давно не было лекарственных препаратов, контролирующих эту болезнь. Многие до сих пор убеждены, что астма – это инвалидизирующее заболевание, при котором невозможно иметь детей. В конце прошлого тысячелетия лечение сводилось к многочисленным капельницам, гормонам и теофедрину, а неумелое использование первых ингаляторов часто заканчивалось безуспешно. Сейчас положение вещей кардинально изменилось, хотя болезнь еще по прежнему не излечима. Благодаря новым представлениям о природе заболевания астмы создан ряд эффективных препаратов и разработаны методы контролирования течения заболевания. Чтобы добиться положительных результатов, необходимы совместные усилия специалистов и их пациентов. Во время беременности тяжесть заболевания зачастую меняется. Около 35% женщин с бронхиальной астмой отмечается улучшение в первом триместре, у трети – ухудшается, у других – остается неизменным. Однако научный анализ свидетельствует о других данных — улучшение заболевания наблюдается только у 14% беременных. Поэтому не стоит полагаться на волю случая, когда речь идет о вашем здоровье и здоровье будущего ребенка. Каждая беременная женщина старается сократить до минимума прием лекарственных препаратов и это вполне обоснованно. Но лечить бронхиальную астму необходимо: вред, который может принести это заболевание, а также вызванная им гипоксия намного больше, чем возможные побочные действия лекарственных препаратов. А если возникнет обострение астмы, то возможна угроза риска жизни будущей матери. Перед каждой женщиной стоит нелегкий выбор, который она должна сделать в пользу планомерного лечения, согласно всем рекомендациям врача. Тесное взаимодействие с врачом – одно из самых главных условий для успешного лечения астмы. Опытный специалист подберет лечение, которое поможет добиться максимальных результатов при минимальном риске. Лечение во время беременности назначается по принципу – «ожидаемая польза должна превышать возможный риск для плода и матери». Самыми строгими требованиями руководствуются в период I триместра беременности, так как это самый уязвимый период. При лечении астмы применяют топические (действующие местно) ингаляционные препараты, поскольку концентрация препарата в крови будет минимальной, а местный эффект для лечения бронхов — максимален. Наилучшим решением является использование ингаляторов, не содержащих фреон. Чтобы снизить риск побочных эффектов следует применять аэрозольные ингаляторы со спейсером. Установлено, что во время беременности и бронхиальной астмы происходят патологические изменения в иммунной системе — она ослабляется. И это вполне естественно, ведь в противном случае женщина не смогла бы выносить ребенка. Но эта палка — о двух концах, к сожалению. Подобное снижение иммунитета оказывает негативное влияние на течение болезни. Постоянное наличие воспалительного процесса в бронхах служит причиной возникающих симптомов. Необходимо лечить не только симптомы болезни (устранять спазмы бронхов), но и саму астму, лечение которой основано на базисной терапии (препаратов для контроля заболевания). Лечение должно быть направленно на контроль над воспалением, а также на подборе необходимых лекарственных препаратов для облегчения симптомов и устранением обострений. В зависимости от тяжести астмы врач определяет объем базисной терапии врач. Рациональная базисная терапия поможет снизить риск обострений и уменьшить назначение препаратов для облегчения симптомов.

Types of bronchial asthma

In some cases, asthma can havenon-allergic origin - due to endocrine changes or severe head injuries. However, in most cases the disease is allergic when the effect of the allergen is accompanied by a spasm of the bronchi, which manifests itself as suffocation. There are two main forms of bronchial asthma:

• Infectious-allergic

The disease develops against the background of such infectiousrespiratory diseases such as pneumonia, tonsillitis, pharyngitis and bronchitis. In this case, the allergen is microorganisms. This form of the disease is the most common.

• Non-infectious-allergic

A number of substances can act as allergensorganic and inorganic origin: dust, pollen, feathers, human dander, animal hair, food allergens (strawberries, citrus fruits, strawberries), medicinal substances and industrial chemicals. The occurrence of this form of bronchial asthma is associated with a hereditary predisposition.

Symptoms of the disease

Whatever form bronchial asthma takes, it is characterized by 3 stages of development:

• PEDAGASH
• Stage of asthma attacks
• Asthmatic status.

In case of pregnancy and bronchial asthmaall these forms are found. At the first stage, chronic pneumonia with bronchospasms, as well as chronic asthmatic bronchitis, are observed. Asphyxiation attacks are not yet present. At the initial stage, they develop periodically. As a rule, with the infectious-allergic form of asthma, asphyxiation attacks occur as a result of chronic diseases of the lungs or bronchi. It is quite easy to recognize asphyxiation attacks: they begin at night and last for several hours. Before the onset of attacks, patients feel a tingling sensation in the throat, tightness in the chest, sneezing and a runny nose begin. There is no sputum, the cough is paroxysmal. In order to inhale, a woman needs to sit up, strain all muscle groups of the neck and chest. Breathing becomes hoarse, whistling, noisy, audible from a distance. The skin becomes covered with sweat, the face becomes bluish. By the end of the attack, liquid and abundant sputum is released. Pregnant women who have not had asthma attacks before pregnancy often do not understand what is happening to them and get scared. Panic in this case is unacceptable, as it can intensify the attack. Try to calm down and call a doctor immediately. By the way, attacks can develop for the first time at any stage of pregnancy. But most often, cases of asthma development are recorded in the first trimester. But do not be too upset - asthma that occurs at the beginning of pregnancy can disappear during the second trimester and the prognosis for the mother and child is very favorable. Asthmatic status is accompanied by severe attacks of suffocation, which do not stop for several hours or even days.

Features of the course of bronchial asthma during pregnancy

In pregnant women with bronchial asthmaEarly toxicosis is often observed - in 36% of cases, the threat of termination of pregnancy is observed in 27%, violations of labor function - in 19% of cases, rapid labor and, as a result, the risk of birth trauma - in 23% of patients. Pregnant women with asthmatic status of bronchial asthma are likely to have a high percentage of premature births, spontaneous miscarriages and cesarean sections. With inadequate treatment, cases of fetal death are noted. With full-term pregnancy, women with bronchial asthma give birth naturally, since attacks of suffocation during childbirth are easy to prevent. And in general - during childbirth, the likelihood of asthma attacks is quite low, especially if during this period the woman took glucocorticoid drugs (hydrocortisone or prednisolone), bronchodilators (ephedrine or) euphyllin. If asthmatic conditions and severe asthma attacks are observed, then early delivery at 37 weeks of pregnancy is recommended.

Postpartum course of the disease

After childbirth, an improvement in the course of the disease is observed.bronchial asthma in 25% of women with a mild form of the disease. In the other 25% of women in labor, the condition worsens, the dose of prednisolone increases significantly. In most women, the condition does not change. Often, bronchial asthma can cause upper respiratory tract disease in newborns. Often, the disease manifests itself in the subsequent years of the baby's life, in rare cases, asthma develops in the first months of life. Therefore, the children of those mothers who have encountered bronchial asthma, the first year of life should be under the close supervision of an allergist and pulmonologist. The earlier the pathology is detected, the easier it will be to cope with it.

Breast-feeding

Pregnant women with bronchial asthma needConsult a specialist on the use of medications during breastfeeding. If taking medications is mandatory, they should be taken at least 3.5 - 4 hours before the start of feeding, then their concentration in the milk will be the lowest. Most drugs get into milk, so this fact cannot be ignored. There are a number of drugs that can be taken by a nursing mother, but along with them, there are drugs that require you to stop breastfeeding for the duration of treatment. In any case, the final word should be left to your doctor.

Recommendations for the reduction of asthma attacks

To minimize trigger factors,provoking exacerbations of bronchial asthma, we offer you the main potential sources that excite them. Triggers of asthma attacks: Household inhalation allergens are the most nasty - it is almost impossible to avoid contact with them. But you still need to try to at least reduce it to a possible minimum. Such allergens include:

• Products of livelihoods of domestic animals (traces of saliva, urine and wool);
• Products of life of cockroaches and colonies of dust mites (books, fur and carpet products);
• Spores of bacteria and mold fungi;
• Tobacco smoke;
• Pollen;
• Household chemicals.

Food allergens are also common, butIt is easier to fight them - just exclude prohibited products from your menu. But, of course, you will be able to do this only if you know what products you are allergic to. And only a doctor can do this.

• Citrus;
• Animal fats;
• Seafood;
• Honey and chocolate;
• Stabilizers and preservatives (nitrates, sulfites, nitrites).

Medicines that result in the initiation of an allergic reaction:

• Aspirin;
• Beta-adrenoblockers, which have a pharmacological effect;
• Drugs prescribed for the treatment of coronary heart disease, myocardial infarction, heart failure.

Non-specific factors:

• Excessive physical activity;
• High humidity of air;
• Temperature changes;
• Stress and prolonged depression.

If the above factors or situations are present, it is necessary to limit their exposure during pregnancy.

Prevention of complications of bronchial asthma

• It is necessary to abandon the products and medicines that cause an allergic reaction (reddening of the skin, rash in the form of urticaria, swelling, nasal congestion, mucous discharge, lachrymation).
• Before pregnancy planning is necessary,give up pets, no matter how much you dislike them. The products of their vital activity can be kept indoors for another six months, so it is necessary to thoroughly clean and get rid of all the harmful bacteria.
• Exclude from home interior potentialsources of dust: carpets, upholstered furniture, old books. If you can not refuse them, cover them with polyethylene covers to protect your own health.
• Choose a model of the air conditioner, which has the function of controlling the humidity of the air. This will save you from ticks and molds that can multiply at a humidity of over 60%.
• Regular wet cleaning of the room. It is advisable that a pregnant woman is not present at the same time, but spent free time in the fresh air.
• Bed linen should be washed at least once a week at a temperature of at least 60 ° C.
• The stove should be equipped with a hood.
• It is forbidden to contact with cigarette smoke, paintwork, fuel vapors and exhaust gases, which easily penetrate the body through the respiratory tract.
• In the workplace of a pregnant woman, there should not be allergens that can cause choking attacks.
• It is necessary to wash hands regularly, not to be overcooled, not to be in crowded places and drafts.
• If during pregnancy planning you havethere was an allergy, this should not be the reason for refusing it. If the allergy occurred during pregnancy, it would be more rational to wait for delivery, and then to conduct research for the presence of specific allergens.

And remember that bronchial asthma is notcontraindication for pregnancy, and even more so a reason to refuse to have children. The main thing is to follow all your doctor's instructions and eliminate the influence of allergens. High-quality and regular control of bronchial asthma throughout the entire period of pregnancy is the key to the birth of a healthy child and the absence of complications for the mother. As you can see, pregnancy and asthma are not mutually exclusive. Happy motherhood to you! We recommend reading:

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