Asthma is a condition that can make it hard to breathe. Asthma does not always cause symptoms. But when a person with asthma has an "attack” or a flare up, it can be very scary. Asthma attacks happen when the airways in the lungs become narrow and inflamed. Asthma can run in families.

Asthma symptoms can include; Wheezing or noisy breathing, coughing often at night or early in the morning or when you exercise, a tight feeling in the chest or trouble breathing. Symptoms can happen each day, each week, or less often. Symptoms can range from mild to severe. Although rare, an episode of asthma can lead to death.

Asthma is the most common condition affecting the lungs during pregnancy. At any given time, up to 8 percent of pregnant women have asthma. Many women worry about how the changes of pregnancy will affect their asthma and if asthma treatments will harm the baby. With appropriate asthma therapy, most pregnant women can breathe easily, have a normal pregnancy, and deliver a healthy baby.

Asthma therapy during pregnancy is most successful when a woman receives regular medical care and follows her treatment plan closely. Before becoming pregnant, women with asthma need to discuss their condition with a healthcare provider. Women who discover that they are pregnant should continue their asthma medications and seek medical advice. Suddenly stopping asthma medications could be harmful to you and your baby.

The severity of asthma during pregnancy varies from one woman to another. Unfortunately, it is difficult to predict the course that asthma will follow in a woman’s first pregnancy. During pregnancy, asthma worsens in about one-third of women, improves in one-third, and remains stable in one-third.

Other known behaviours of asthma in pregnancies include; an increase in symptoms is often seen between weeks 29 and 36 of pregnancy in those women whose asthma worsens in pregnancy, asthma is generally less severe during the last month of pregnancy, labor and delivery do not usually worsen asthma, commonly improves gradually throughout pregnancy, and the presentation of asthma symptoms during the first pregnancy is often similar in subsequent pregnancies.

The factors that increase or decrease the risk of asthma attacks during pregnancy are not entirely clear. The likelihood of these attacks is not constant throughout pregnancy. Attacks are more likely during weeks 17 through 24 of pregnancy. The cause for this pattern is not clearly known, although it may be because some women stop using asthma-controlling drugs when they realize they are pregnant, increasing their risk for attacks.

Women who have asthma have a small increase in the risk for certain complications of pregnancy compared to women who do not have asthma. These complications include; high blood pressure (or also known as preeclampsia), having a premature delivery, needing a cesarean delivery,or having a baby that is small for their age

It is however important to know that the majority of women with asthma and their babies do NOT have any complications during pregnancy. Good control of asthma during pregnancy reduces the risk of these complications.

If you take prescription or non-prescription medications, these should be reviewed with a healthcare provider. Some medications are safe during pregnancy while others are not. An alternate medication can be substituted for an unsafe drug.A continuous medical review by a doctor about asthma control is paramount for early detection of asthma and prevents attacks. These visits shouldn’t be confused with the routine antenatal visits as the doctors for antenatal and for asthma could be different.

With a few exceptions, the medications used to treat asthma during pregnancy are similar to the medications used to treat asthma at other times during a person’s life. The type and dose of asthma medications will depend upon many factors judged by your doctor. Severe untreated asthma attacks can reduce the oxygen supply to the baby. In most cases, undertreated asthma poses a far greater risk to both the mother and the baby than the use of asthma-controlling drugs. Therefore, it is important to take asthma medications on a regular basis to prevent asthma symptoms.

In addition to the medicines for asthma, avoiding triggers for attacks is important in controlling asthma, with or without pregnancy. Triggers are things that cause asthma symptoms or make symptoms worse. Common triggers include dust, mold, dogs, cats, pollen, plants, and cigarette smoke. Stop smoking, and avoid being near people who smoke.

Dr. Ian Shyaka is a

General Practitioner at Rwanda Military Hospital

email: iangashugi@gmail.com