Title: Asthma in Pregnancy
- describe the pathophysiology of asthma, effects on pregnancy and potential complications
- identify current recommendations for asthma management in pregnancy, including pharmacologic and collaborative approaches
- examine key nursing roles and responsibilities in providing care for pregnant patients with asthma
Case: PC is a 34 yo G7P3033 who presented at 10 weeks gestation. Her PMH is significant for “asthma with meds.” Her prior obstetrical history was unremarkable; her last delivery was 2 years ago. This pregnancy was uncomplicated until 34 weeks gestation when PC presented with a cough and shortness of breath; she was treated with antibiotics. At 38 weeks gestation, PC was hospitalized after complaints of shortness of breath and a cough, for an acute asthma exacerbation with hypoxia. Her treatment plan included short-acting bronchodilator nebulizer treatments prn and intravenous corticosteroids and antibiotics. She was provided with supplemental oxygen by nasal canula as needed. Fetal monitoring was done intermittently; she had three biophysical profiles during her stay. Fifty hours after admission a fetal demise was suspected during a routine assessment, which was later confirmed by sonogram.
Conclusion: This case highlights the unpredictable course of asthma in pregnancy and the complexities in management. It is essential that nurses working with pregnant patients perform comprehensive assessments and histories, and recognize the implications of identified actual and potential health problems. Nurses using electronic fetal monitoring must be skilled in assessment and interpretation of data, as well as possess the knowledge to utilize additional surveillance measures to assess fetal well being. Communication and collaboration between members of the interdisciplinary health care team, in a timely, effective manner, are essential to promote the best possible outcomes.
Keywords: asthma, pregnancy, fetal well-being