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First Aid & Emergencies

Acute Asthma Attack in Pregnancy Treatment

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1. Symptoms of an acute asthma attack in pregnancy include:

  • Difficulty talking, walking, or thinking because of shortness of breath
  • Neck and ribs moving in during breathing
  • Blue- or gray-looking skin
  • Peak flow reading below 60% of personal best
  • Decrease in fetal kick count if the baby is in distress

2. Follow the Woman’s Asthma Plan, if Possible

  • Find out if the woman has an individualized treatment plan for asthma attack in pregnancy from a health care provider.
  • Follow the plan. It may say to call the woman's health care provider about when to give quick-relief medicine and whether additional medicines are needed.

3. Give Asthma First Aid

If the woman doesn't have an asthma action plan:

  • Sit the woman upright comfortably and loosen tight clothing.
  • If woman has asthma medication, such as an inhaler, help her use it.
  • If woman doesn't have an inhaler, use one from a first aid kit or borrow someone else’s.

4. Use Inhaler With a Spacer, if Possible

  • Remove cap and shake inhaler well.
  • Insert inhaler into spacer.
  • Have her breathe out completely and put mouth tightly around spacer mouthpiece.
  • Press inhaler once to deliver a puff.
  • Have her breathe in slowly through the mouth and then hold breath for 10 seconds.
  • Give a total of four puffs, waiting about a minute between each puff.

5. Use Inhaler Without a Spacer, if Necessary

  • Remove cap and shake inhaler well.
  • Have woman breathe out all the way and seal lips tightly around inhaler mouthpiece.
  • As woman starts to breathe in slowly, press down on the inhaler one time.
  • Have her keep breathing in as slowly and deeply as possible (about five to seven seconds) and then hold breath for 10 seconds.
  • Give a total of four puffs, waiting about one minute between each puff.

6. Continue Using Inhaler if Breathing Is Still a Problem

  • After four puffs, wait four minutes. If the woman still has trouble breathing, give another set of four puffs.
  • If there’s still little or no improvement, continue giving four puffs every four minutes until ambulance arrives.
  • If the woman is having a severe attack, give up to six to eight puffs every five minutes.

7. Monitor the Woman Until Help Arrives

  • Do not mistake drowsiness as a sign of improvement; it could mean asthma is worsening.
  • Do not assume her asthma is improving if you no longer hear wheezing.

8. Follow Up

  • An emergency room doctor may give the woman oxygen, inhaled medications, and intravenous steroids. All can be given without risk to the baby.
  • The woman may be hospitalized so that she can be carefully monitored.

WebMD Medical Reference

Reviewed by Varnada Karriem-Norwood, MD on January 10, 2014

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