21 February 2020 Because I am pregnant, is it important to control allergic disease? Pregnancy is a period when several hormonal changes occur . These hormonal changes can interfere with the control of an underlying disease , pre-existing to conception, or even trigger the development of new diseases . This paradigm can also be applied to allergic diseases during pregnancy . It is recommended that women with allergy have their illness controlled during pregnancy . This will prevent undesirable and preventable complications for both mother and child. Poor control can increase the risk of complications in pregnancy and childbirth and even interfere with the fetus health. The pregnant woman with allergic disease must continue her maintenance therapy for the disease control, as long as it is properly advised and accompanied by her attending physician . For pregnant woman, the medical approach is sometimes multidisciplinary , involving the general practitioner and / or the obstetrician and the allergologist. An uncontrolled allergic disease, whether asthma, rhinitis, urticaria or other, poses a higher risk to the fetus and the mother than the risk associated with regular anti-allergic medication. Asthma and pregnancy Asthma symptoms and severity can aggravate , improve or maintain during pregnancy. The worsening of asthma during pregnancy is often related to a previously (before pregnancy) poor control but also to a possible interruption of maintenance therapy with the beginning of the pregnancy (for example, daily inhaled medication). It should be noted that asthma is not a limitation or contraindication to pregnancy , even if it is serious, since with currently available therapies it is possible to achieve a good control of the disease and a good evolution of the fetus. What is the most appropriate treatment for asthma in a pregnant woman? The most appropriate therapeutic strategy should be evaluated by the attending physician together with the allergologist , in order to avoid exacerbations, considering that there are currently drugs safe and effective during pregnancy. The allergen avoidance measures must also be implemented. Pregnant asthmatics should be followed up regularly during pregnancy , to ensure a good control of the disease and of fetal development. Rhinitis and pregnancy Allergic rhinitis is very common in pregnant women, given the prevalence of this allergic disease in the general population. However, in pregnant women, edema of the nasal mucosa and hormonal changes may influence the control of pre-existing allergic rhinitis , often causing nasal obstruction. What is the most appropriate treatment for rhinitis in a pregnant woman? It is important to maintain stability of rhinitis by avoiding symptoms , using appropriate medication that can be taken during pregnancy. For example, some antihistamines and nasal corticosteroids are safe and may be indicated by your attending physician . I am allergic: should I be observed in immunoallergology consultation before becoming pregnant? Women with a suspected or confirmed allergic disease should be observed in immunoallergology consultation for allergy study , including, for example, skin prick tests, provocation tests or other tests needed to confirm the diagnosis or study the allergic disease in cause. In allergic women it is often important to exclude allergies to medications or anesthetics which may be necessary during pregnancy and / or childbirth. The evaluation of the usual antiallergic medication is essential , so that changes / adjustments can be made considering the drugs recommended as safe during pregnancy and puerperium. The authors of this text are the following allergologists from the Hospital da Luz network: Luís Miguel Borrego, Ana Morais Mendes, Ana Reis Ferreira, Andreia Ferrão, Carlos Braga, Cristina Lopes, Diana Pereira da Silva, Filipa Semedo, Isabel Costa Silva, João Gaspar Marques, Pedro Carreiro Martins, Marta Salgado, Nuno Sousa, Rosa Anita Fernandes, Susana Piedade The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
