Pregnancy is a period of intense changes in women’s life and sometimes it can be complicated by pre-existing allergies.
Asthma is one of the most serious conditions which may be present during pregnancy, but a well-controlled asthma is not associated with a higher risk for the mother or the foetus. The second trimester is when worsening is more frequent. It is highly recommended to have a well controlled asthma prior to or as soon as the woman becomes pregnant. In allergic asthma it will be very important to avoid specific triggers which may worsen symptoms, such as house dust, molds or pets, and at the same time, avoiding other substances that may deteriorate asthma such as tobacco smoke, strong odours, or chemical and paint fumes.
Your physician should review your asthma medication but, nowadays, there are several anti-inflammatory inhalers which act as preventive treatment that can be used safely. Budesonide has been the most frequently used controller drug during pregnancy without side effects for the foetus but there are other that have also been shown to be safe. Rescue medications such as bronchodilators have been proved safe and should be used in case of acute symptoms. During pregnancy, inhaled medications are preferred because of their low absorption, but sometimes oral or injected steroids may be necessary during a few days in case of severe exacerbations. In any case, the lowest dose that is enough to control symptoms is recommended for all treatments.
Rhinitis is a very frequent condition during pregnancy. It can be caused by allergens but it often occurs because of hormonal changes during the first period of pregnancy. It may cause nasal blockage and increased nasal discharge. If drug treatment is needed, antihistamines like cholrpheniramine, loratadine or cetirizine may be used. At the same time, corticosteroid nasal sprays should be considered during pregnancy in case of persistent symptoms, being budesonide the drug of choice.
Urticaria and allergy-like rashes may appear during pregnancy and the use of antihistamines may be necessary. There is a specific condition called Pruritus and Urticarial Papules and Plaques in Pregnancy characterised by itchy eruptions, mainly on lower abdomen and upper thighs that disappears after delivery.
Eczema often improves during pregnancy, probably due to the increase of natural steroid-like hormones.
Starting a new allergen immunotherapy (allergy vaccine, either subcutaneous or sublingual) during pregnancy is not recommended, but an established treatment does not need to be discontinued.
Flu vaccine is recommended for all patients with moderate to severe asthma, and there is no evidence of any risk either for the mother or the foetus.
During delivery and the nursing period most medications used in pregnancy may also be used. Although nearly all medications are secreted in breast milk, concentrations are very low and rarely present problems for the infant. In any case, consult your physician about your particular treatment regime.
It is very important to know that although pregnant woman are afraid to use any medication because of the safety of their baby, it is better to be adequately controlled with proper medication than to suffer any complications because of an uncontrolled disease. In case of an emergency situation, such as anaphylaxis, all medication required may be used to treat the mother.