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Acute Asthma Attack in Pregnancy Treatment

Medically Reviewed by Sabrina Felson, MD on August 23, 2020

Call 911

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

  • Shortness of breath
  • Wheezing with fluids or mucus.
  • 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. 
  • Give the woman a fast-relief rescue inhaler if they have one.

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 them use it.
  • If woman doesn't have an inhaler, use one from a first aid kit or borrow someone else’s. The medication  should be a short-acting, rescue inhaler (not the prevention inhalers)--specifically albuterol. In an acute asthma attack the primary medication used is always the rescue inhaler albuterol either through an inhaler or nebulizer if they have one.

4. Use Inhaler With a Spacer, if Possible

  • Remove cap and shake inhaler well.
  • Insert inhaler into spacer.
  • Have them breathe out completely and put mouth tightly around spacer mouthpiece.
  • Press inhaler once to deliver a puff.
  • Have them 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 them 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 their 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 they can be carefully monitored.
WebMD Medical Reference

Sources

SOURCES:

National Jewish Health: “Asthma and Pregnancy: Asthma Management.”

Ohio State University Medical Center: “Asthma and Pregnancy.”

Handal, K. The American Red Cross First Aid and Safety Handbook, Little, Brown and Company, 1992.

National Asthma Council Australia: “First Aid for Asthma.”

Cleveland Clinic: “How to Use a Metered Dose Inhaler.”

 

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