You are asked to see a newly diagnosed asthmatic woman who is eight weeks’ pregnant. She
is not on any Rx at the moment. Her PEFR diary shows wide diurnal variations and she also gives
a past history of eczema.
Which of the following is true?
A. Short-acting β2-agonists are contraindicated during the first trimester
B. Inhaled steroids are associated with major congenital deformities
C. A leukotriene-receptor antagonist is the first-line Rx
D. Low dose inhaled corticosteroids would be considered acceptable
E. Steroid tablets are teratogenic
Answer:
D (Low dose inhaled corticosteroids would be considered acceptable)
Discussion: In general, the medicines used for asthma are safe during pregnancy.
Leukotriene-receptor antagonists are not the first-line Rx during pregnancy. However, they may be continued in women who have demonstrated significant improvement in asthma control with these agents prior to pregnancy.
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