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Obstetric complications in the 3rd trimester of pregnancy in women with asthma

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Abstract

DOI: 10.32364/2618-8430-2024-7-2-2

A.A. Pashchenko^1,2, Yu.E. Dobrokhotova¹, D.S. Fomina^2,3

¹Pirogov Russian National Research Medical University, Moscow, Russian Federation

²City Clinical Hospital No. 52, Moscow, Russian Federation

³I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation

Aim: to analyze the rate of asthma-associated obstetric complications in the third trimester of pregnancy, with attention to the severity and level of symptom control.

Patients and Methods: a retrospective phase involved the analysis of the course of the third trimester of pregnancy in 120 women with asthma. The women were divided into five groups: mild intermittent asthma (n=34), mild persistent controlled asthma (n=40), mild persistent poorly controlled asthma (n=10), moderate to severe persistent controlled asthma (n=26), and moderate to severe persistent poorly controlled asthma (n=10). The prospective phase included examination and treatment of pregnant women in the groups with uncontrolled asthma (n=20). The level of symptom control was assessed using the Asthma Control Test (ACT). Additionally, nitric oxide in exhaled air (NOex) was measured. The control group included 20 women without allergic disorders.

Results: the study demonstrated an association between the level of symptom control and the development of associated hypertensive disorders. Severe preeclampsia was reported only in moderate to severe poorly controlled asthma. A significant correlation was revealed between ACT, NOex level, and de novo increase in systolic blood pressure (BP) in the third trimester (Rs=0.581; Rs=0.828). C-section was most often performed for fetal indications (acute hypoxia) in women with moderate to severe persistent poorly controlled asthma. These findings indicate that the choice of delivery method should be based on the level of symptom control at the end of the third trimester, rather than disease severity. Achieving complete control of asthma in pregnant women reduces the risk of acute fetal hypoxia and the rate of emergency C-sections.

Conclusions: achieving and maintaining complete asthma control during pregnancy reduces the risk of associated obstetric complications and improves perinatal and maternal outcomes.

Keywords: asthma, pregnancy, obstetric complications, hypertension, asthma-associated obstetric complications, C-section.

For citation: Pashchenko A.A., Dobrokhotova Yu.E., Fomina D.S. Obstetric complications in the 3rd trimester of pregnancy in women with asthma. Russian Journal of Woman and Child Health. 2024;7(2):98–103 (in Russ.). DOI: 10.32364/2618-8430-2024-7-2-2.

ABOUT THE AUTHORS:

Aleksandr A. Pashchenko — assistant of the Department of Obstetrics and Gynecology of the Medical Faculty, Pirogov Russian National Research Medical University; 1, Ostrovityanov str., Moscow, 117437, Russian Federation; obstetrician & gynecologist of the Delivery Department of the Maternity Hospital, City Clinical Hospital No. 52; 3, Pekhotnaya str., Moscow, 123182, Russian Federation; ORCID iD 0000-0003- 0202-2740.

Yuliya E. Dobrokhotova — Dr. Sc. (Med.), Professor, Head of the Department of Obstetrics and Gynecology of the Medical Faculty, Pirogov Russian National Research Medical University; 1, Ostrovityanov str., Moscow, 117437, Russian Federation; ORCID iD 0000-0002-7830-2290.

Darya S. Fomina — C. Sc. (Med.), Head of the Moscow City Scientific Practical Center for Allergy and Immunology, City Clinical Hospital No. 52; 3, Pekhotnaya str., Moscow, 123182, Russian Federation; associate professor of the Department of Clinical Immunology and Allergy, I.M. Sechenov First Moscow State Medical University (Sechenov University); 8, Build. 2, Trubetskaya str., Moscow, 119991, Russian Federation; ORCID iD 0000- 0002-5083-6637.

Contact information: Aleksandr A. Pashchenko, e-mail: al.pashenko2018@yandex.ru.

Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.

There is no conflict of interest.

Received 05.03.2024.

Revised 28.03.2024.

Accepted 22.04.2024.

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