Asthma in pregnancy

A prospective study of the course of asthma in pregnancy was performed in a group of 27 women (mild asthma 22.2%, severe asthma 22.2%, moderate asthma 55.6%). The stale of asthma in each trimester was assessed on the basis of anamnesis, physical examination, pulmonary function tests and arterial blo od gas measurements and compared with test results during the period of one year before pregnancy. In the whole study group FEV1 and FVC parameters di d not statistically significantly differ in the three trimesters of pregnan cy. An analysis of arterial blood gas measurements showed that in the 3(rd) trimester statistically significant increase in ph occurs, leading to resp iratory alkalosis. 40.8% of the studied women manifested exacerbation of as thma, the others represented either improvement (25.9%) or stability (33.3% ). No interrelationship was found between the course of asthma in pregnancy and the patients' age or the duration of the disease. In the group of wome n suffering from aggravation there were exclusively patients with severe (4 5.5%) and moderate asthma (64.5%). In the group that reported improvement o r stability there were almost solely women with mild (37.5%) or moderate as thma (56.2%). The study shows that the course of asthma in pregnant patient s is determined by its severity before pregnancy. Exacerbation of symptoms mostly occurred during the 1(st) trimester and so did the cases requiring h ospitalisation (75%). Aggravation of the state of asthma most frequently wa s caused by reductions of asthma medication in the 1(st) trimester and by r espiratory tract infections. The tendencies should be taken into considerat ion in developing an optimal asthma therapy in pregnancy.