Asthma Attack in Pregnancy

Call 911

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.

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.”