Asthma

Question 1

Outline management of an acute exacerbation of asthma in pregnancy

Answer 1

• Aim for sats ≥95%:
  
  • Supplemental oxygen: start with 3-4L/min NP, adjust FiO2 as needed.
• Salbutamol 6 puffs Q20mins via spacer or neubliser.
• Inhaled ipratropium bromide
• Glucocorticoids: prednisone 40-80 mg po OR methylprednisolone 60-80 mg Q12H IV
• MgSulf 2g over 20 mins.
• Fetal monitoring: CTG
• Consider investigations or differentials:
  
  • CXR
• MDT: obstetrics, physician, ICU, anaesthetist
• Consider delivery if resp arrest, not improving or fetal distress