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GEBELİKDE ASTIM

Journal Name:

  • Cerrahpaşa Tıp Dergisi

Publication Year:

  • 2001

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Asthma is one of the most common potentially serious diseases complicating pregnancy. Epidemiological studies have shown that approximately %1-4 of pregnancies are complicated by asthma. These percentages are likely to be underestimated because in many cases the condition will be undiagnosed or not recorded. Under treatment of pregnant asthmatics owing to the adverse pharmacological effects of the drugs on the fetus is another problem. Poor control and exacerbations of asthma may result in maternal hypoxia with resultant decreases in fetal oxygen saturation causing fetal hypoxia. As a result, optimal management of asthma during pregnancy requires consideration of the altered pulmonary physiology during pregnancy, the differential diagnosis of gestational asthma, the effect of pregnancy on asthma and the potential effects of asthma on the outcome of pregnancy. The goals of treatment are to maintain normal pulmonary function, prevent exacerbations and avoid adverse effects of medications.
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Abstract (Original Language): 
Astımı olan gebeler kontrol edilemeyen astımın anne ve fetüs üzerindeki etkileri nedeniyle yüksek riskli hastalar olarak kabul edilmelidirler. Ciddi ve kontrol edilemeyen astım, gebelik sırasında kullanı- lacak astım ilaçlarının yan etkilerine göre çok daha fazla olumsuz etkiler taşır. Astı- mın optimal kontrolu ile bu olgularda fetüs ve doğum, astımı olmayanlarla aynı prognozu izler. Gebelik sırasındaki astım alevlenmeleri oksijen saturasyonunu azaltarak hipoksiye yol açar. Hipoksi özellikle fetüs üzerinde zararlı olur. Bununla beraber, hiçbir ilacın tamamen yan etkisiz olmad ığı akıldan çıkarılmamalı ve bilhassa birinci trimestirde multipl ilaç uygulamas ından kaçınılarak fetal riski minimale indirmek için kullanılabilecek en düşük doz verilmelidir. Gebelerde astım tedavisi için genel farmakolojik tedavi ilkelerinin yanında dikkat edilmesi gereken noktalar: 1) maternal semptomlar ile fetal gelişim objektif olarak yakından izlenmeli 2) çevresel astımı indükleyici faktörler çok iyi kontrol edilmeli 3) hasta eğitimine en az ilaç tedavisi kadar büyük önem verilmelidir. Gerektiğinde tedavi için gebe olmayan kadınlar kadar agresif bir protokol uygulanmal ıdır. Aeresol tedavi yaklaşımı her zaman ön planda tutulmalı bu yolla uygulanan ilaçların sistemik etkilerinin minimale indirilebileceği unutulmamalıdır. Tedavi protokolünün başarısız kalması durumunda oral kortikosteroid uygulamas ından kaçınılmamalıdır.
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  • 1
60-67
  • Turkish

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