ABSTRACT
Asthma is the most common respiratory disorder occurring during pregnancy, affecting about 5% of women of child-bearing age. The prevalence of asthma in pregnancy has been reported to be 1% but this is likely to be a substantial underestimate. The effects of uncontrolled asthma are undoubtedly serious: severe exacerbations cause fetal hypoxia and a severe asthma attack is potentially fatal for the mother and fetus. Experience with longer-acting bronchodilators such as salmeterol, fenoterol and eformoterol is limited and these agents should preferably be avoided unless control cannot be achieved with other agents. Ipratropium or oxitropium may be used by inhalation in the management of chronic asthma in patients who already require high-dose inhaled corticosteroids. Theophylline may be introduced at step three or four of the British Thoracic Society (BTS) asthma guidelines. Modified release preparations may be particularly useful in controlling nocturnal symptoms.
