Respiratory conditions

Question 1

What is the most common respiratory disease?

Answer 1

Asthma

Question 2

What are some triggers of asthma?

Answer 2

Smoking
Allergies
Upper respiratory tract infection
sinusitis
exercise
Medications - aspirin, NSAIDs, beta-blockers, or anything provoking anaphylaxis
Environmental toxins
Humidity
Anxiety/emotional distress

Question 3

What type of drugs are used to manage asthma and are they safe in pregnancy?

Answer 3

For acute asthma - beta-2 agonists such as salbutamol, terbutaline and fenoterol - Category A drugs so safe in pregnancy

Corticosteriods - sometimes necessary - inhaled = safe, oral form = some harm in animal trials in first trimester (cleft palate and placental abnormalities), nothing in human trials - benefits may outweigh risks if life threatening.

Oxygen therapy given in acute cases to keep sats above 95%

Question 4

What are the symptoms of asthma?

Answer 4

Intermittent episodes of wheeze, SOB, chest tightness, and cough.

Question 5

How does pregnancy impact on pre-existing asthma?

Answer 5

1/3rd of women will get better, 1/3rd will stay the same, and 1/3rd will worsen.

Question 6

What occurs in poorly controlled asthma?

Answer 6

increased maternal hypoxaemia and reduction of uterine artery blood flow secondary to hypocapnic vasoconstriction.

Increased incidence of hyperemesis, haemorrhage and preeclampsia.

Babies more likely LBW and preterm and to suffer neonatal hypoxia from labour complications.

Question 7

How is active TB managed in pregnancy?

Answer 7

If already on medication - woman continues. If new case in pregnancy - commence medication. Protects the fetus. Drugs are Category A

Shorten second stage with instrumental delivery.

Breastfeeding contraindicated for active TB.