Souza Renato Teixeira, Bonomi Inessa Beraldo de Andrade, Maganha Carlos Alberto, Ferreira Elton Carlos, Solha Sara Tossa Gomes, Vetorazzi Janete, Mattar Rosiane, de Carvalho-Pinto Regina Maria, Bártholo Thiago Prudente, Caetano Lilian Serrasqueiro Ballini
Universidade Estadual de Campinas CampinasSP Brazil Universidade Estadual de Campinas, Campinas, SP, Brazil.
Universidade Professor Edson Antônio Velano Belo HorizonteMG Brazil Universidade Professor Edson Antônio Velano, Curso de Medicina, Belo Horizonte, MG, Brazil.
Rev Bras Ginecol Obstet. 2025 Jul 2;47. doi: 10.61622/rbgo/2025FPS5. eCollection 2025.
•Asthma is the most common lung disease during pregnancy and its diagnosis is determined in the same way in pregnant and non-pregnant women. •Spirometry is a simple test used to confirm and monitor the disease, and has no contraindications for use during pregnancy both in the pre- and post-bronchodilator phase. •The control of asthma before pregnancy is the main predictor of disease severity during pregnancy. Other predictors of asthma attacks include smoking, overweight and obesity. •Inadvertent interruption of maintenance medication is one of the factors most associated with exacerbation and complications related to asthma during pregnancy. •In general, treatment of pregnant women with asthma should be similar to that of non-pregnant women. Inhaled corticosteroids (ICS) are the main medication to achieve and maintain control of the disease during pregnancy. •Corticosteroids prescribed for maintenance treatment of chronic asthma have no effect on accelerating fetal maturity. The usual protocol should be used when this acceleration is necessary. •Moderate asthma exacerbation includes at least one of the following criteria: 1) worsening of respiratory symptoms; 2) worsening of lung function; 3) increased use of inhaled pump medication (e.g., salbutamol; at least two-day duration). •Severe asthma exacerbation includes at least one of the following criteria: 1) use of systemic corticosteroids or increased dose of maintenance oral corticosteroids for at least three days; 2) hospitalization or visit to the emergency room (ER) due to asthma requiring the use of systemic corticosteroids. •Asthma does not normally affect labor or the choice of delivery route.
•哮喘是孕期最常见的肺部疾病,其诊断方法在孕妇和非孕妇中相同。
•肺功能测定是一种用于确诊和监测该疾病的简单检查,在支气管扩张剂使用前和使用后阶段,孕期均可使用,无禁忌。
•孕前哮喘的控制情况是孕期疾病严重程度的主要预测指标。哮喘发作的其他预测因素包括吸烟、超重和肥胖。
•维持药物治疗的意外中断是孕期哮喘加重及相关并发症最相关的因素之一。
•一般来说,哮喘孕妇的治疗应与非孕妇相似。吸入性糖皮质激素(ICS)是孕期实现和维持疾病控制的主要药物。
•用于慢性哮喘维持治疗的糖皮质激素对加速胎儿成熟无影响。如需加速胎儿成熟,应采用常规方案。
•中度哮喘加重至少包括以下标准之一:1)呼吸道症状恶化;2)肺功能恶化;3)吸入泵药物(如沙丁胺醇)使用增加(持续至少两天)。
•重度哮喘加重至少包括以下标准之一:1)使用全身性糖皮质激素或维持口服糖皮质激素剂量增加至少三天;2)因哮喘需使用全身性糖皮质激素而住院或前往急诊室就诊。
•哮喘通常不影响分娩或分娩方式的选择。