Severe Acute Asthma

Abstract

Asthma is the most common respiratory disorder to complicate pregnancy. It remains a high-risk condition despite advances in therapy.

Previous studies have defined asthma exacerbations as any asthma-related event that involved one or more of the following: a hospital admission, an unscheduled visit to a doctor, a course of oral steroids, an increase in medication use, or decreased peak expiratory flow rate. Among those with mild, moderate, and severe asthma, the exacerbation rates have been reported as 13%, 26%, and 52%, respectively. The corresponding rates of exacerbations leading to hospitalization were 2%, 7%, and 27%, respectively. Those who worsen are rendered at risk for developing a critical asthma syndrome, i.e., status asthmaticus (SA) and near-fatal asthma (NFA). The optimal management of a critically ill pregnant patient due to worsening asthma can be challenging, with both mother and fetus at risk, especially from hypoxemia. Therefore, subspecialist management within a multidisciplinary Intensive Care Unit (ICU), including intensivists, asthma specialists, neonatologists, and obstetricians experienced in high-risk pregnancies, is vital for ultimate safety and success.