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ANNOUNCER: Doctors say a pregnant woman with asthma may hurt herself and her unborn child if her disease goes untreated.
EMILY DIMANGO, MD: Women with asthma who become pregnant should not take matters into their own hands, even if they think that their asthma is well-controlled. They really need to see a doctor about it.
ALLAN STILLERMAN, MD: I would recommend to pregnant women that they seek the best control of their asthma while pregnant, before they're pregnant and after they're pregnant. They can best accomplish this by seeking the supervisory care of both an allergist or pulmonologist in addition to their obstetrician and gynecologist to seek a comprehensive approach to the management of their asthma and their pregnancy.
ANNOUNCER: When pregnant women under treat their asthma or do not treat it at all it's often because they don't realize the full impact of their disease.
EMILY DIMANGO, MD: People with asthma tend to underestimate the severity of their disease. Not because they're denying their disease, but they tend to become adjusted to it or acclimated to it. So the fact that they can't walk up a flight of stairs becomes normal for them, when in fact with use of good controller medications, that's not necessary. So being short of breath, waking up at night from asthma is not normal. These symptoms can be controlled and can be eliminated with proper use of asthma medication, both during pregnancy and just during everyday life as well.
ANNOUNCER: Sometimes, women avoid treatment for asthma for fear that drugs may harm their unborn child. But doctors say there's little reason to worry, whether treatment is for occasional flare-ups, or more persistent asthma.
RUSSELL SETTIPANE, MD: The medications that we use for asthma, in general, are very, very safe and their benefits greatly outweigh the risks in terms of the pregnancy.
ANNOUNCER: The severity of a woman's asthma during pregnancy is hard to predict.
MICHAEL SCHATZ, MD: Not only may asthma affect pregnancy, but pregnancy appears able to affect the course of asthma as well. The data in the literature would suggest that about a third of women get worse during pregnancy their asthma worsens about a third of women improve and about a third of women stay the same.
ANNOUNCER: A woman's experience during a previous pregnancy offers some guidance about the likely course of her asthma.
ALLAN STILLERMAN, MD: The main predictive factor which is going to determine what impact the pregnancy has on a female's asthma is the pattern that that patient experienced from a former pregnancy. That tends to be consistent.
RUSSELL SETTIPANE, MD: We do know that when somebody has asthma -- and particularly when they're pregnant, one of the most important things to do is... avoid the triggers that may be contributing to the asthma such as dust mites, animal danders, mold spores; and avoid irritants, such as cigarette smoke or irritants in the workplace.
ALLAN STILLERMAN, MD: Aspirin may trigger asthma and therefore, if possible, the aspirin and aspirin-like drug should be avoided.
RUSSELL SETTIPANE, MD: One of the biggest triggers that we see are viral respiratory infections and although we can't prevent colds, we can prevent the influenza, the 'flu, with the influenza vaccine. And all pregnant asthmatics who have moderate or severe asthma should, should be given the influenza vaccine to prevent the occurrence of the 'flu during pregnancy.
ANNOUNCER: Even if a woman has had problems with asthma during her pregnancy, doctors say she'll likely be symptom-free by the time she delivers her child.
EMILY DIMANGO, MD: Worsening of asthma attacks, interestingly, is not very common during labor and delivery. In fact, after about 36 weeks of gestation, asthma seems to quiet down a bit and it is quite unusual for a pregnant woman to be having an asthma exacerbation during their labor and delivery.
MICHAEL SCHATZ, MD: Most of the data has suggested perhaps no more than one in ten asthmatic women have problems during labor and delivery, and most of those are mild and taken care of by the inhaler. It actually seems that some of the hormones circulating at that time might prevent asthma.
ANNOUNCER: Doctors say the best care requires a knowledgeable patient, and good lines of communication.
MICHAEL SCHATZ, MD: Another very important aspect of managing asthma during pregnancy is for the woman herself to really know about her asthma, what she's taking and why and to be able to communicate when things aren't going well to the physician working with her.
ANNOUNCER: Sometimes a woman's general doctor has a great deal of experience managing asthma. But specialists are always appropriate members of the health team for a pregnant woman with asthma.
MICHAEL SCHATZ, MD: For patients who have asthma more than just intermittently, I would certainly recommend working with an asthma specialist, along with the obstetrician, because I think asthma specialists working with the patient having the best chance of making sure that that asthma is going to be as well controlled as possible, with the safest type of therapy.
RUSSELL SETTIPANE, MD: If expert care is given we're going to see better management of asthma and end up with a healthier mother and baby.
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