ABSTRACT
Pregnancy is associated with alterations in maternal physiology that are impacted by inadequate control of asthma. When there is poorly controlled or uncontrolled asthma that results in maternal hypoxemia or hypoxia, the fetus also can be stressed when the low-oxygen intrauterine environment becomes compromised. Women living at high altitudes in Colorado deliver lighter-weight babies; they are reported to be 121 g lighter for 1000 m of elevation. At baseline, the respiratory rate, vital capacity, and total lung capacity generally are unchanged. The residual volume and functional residual capacity are reduced as the diaphragm is more cephalad and flattened. The patient presented has persistent asthma requiring combination therapy; thus, she is at risk of worsening asthma as compared with the “prototype” pregnant woman with persistent asthma who is managed with an inhaled corticosteroid as controller therapy. The benefits of medications required to achieve effective control of asthma outweigh any potential risks.
