Asthma and allergy during pregnancy:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
2000
|
| Schriftenreihe: | Immunology and allergy clinics of North America
20,4 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XIV S., S. 663 - 878 graph. Darst. |
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Datensatz im Suchindex
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| adam_text | ASTHMA AND ALLERGY DURING PREGNANCY
CONTENTS
Preface xiii
Michael Schatz
Respiratory Physiologic Changes in Pregnancy 663
Robert A. Wise and Albert J. Polito
This article reviews the respiratory functional changes that ac¬
company pregnancy. The major physiologic changes that occur in
pregnancy include increased minute ventilation, which is caused
by increased respiratory center sensitivity and drive, a compen¬
sated respiratory alkalosis, and a low expiratory reserve volume.
The vital capacity and measures of forced expiration are well
preserved. Patients with many lung diseases tolerate pregnancy
well, with the exception of those with pulmonary hypertension
or chronic respiratory insufficiency from parenchymal or neuro
muscular disease.
Perinatal Epidemiology: Studying the Effects of Illness
and Medications During Pregnancy 673
Diana B. Petitti
Events during pregnancy are important influences on the out¬
come of pregnancy and the health and well being of the newborn.
They also may affect childhood and adult health. Perinatal epide¬
miology has developed as a subspecialty of epidemiology that
concerns itself with the effects of events during pregnancy on
pregnancy outcome. Because of the inability to randomize many
exposures during pregnancy and the difficulty of conducting
large scale randomized trials in pregnant women, most perinatal
epidemiology research is nonexperimental. Nonexperimental
studies are subject to problems of bias and confounding that
characterize all nonexperimental research. The study of the effects
IMMUNOLOGY AND ALLERGY CLINICS OF NORTH AMERICA
VOLUME 20 • NUMBER 4 • NOVEMBER 2000 vii
of illness and medications during pregnancy are plagued by
special problems related to exposure assessment, intermediate
variables, and low statistical power.
General Considerations Regarding the Use of Asthma
and Allergy Medications During Pregnancy 687
Janine E. Polifka and Kenneth Lyons Jones
Many asthma patients must continue treatment throughout their
pregnancy to maintain effective control of their asthma. Health
care professionals need to have a thorough understanding of
how drugs influence embryonic and fetal development so that
potentially harmful exposures can be avoided. This article re¬
views the general principles of teratology and how to assess
teratogenic risk in humans. Recommendations for counseling
pregnant women with asthma also are provided.
Medical Legal Aspects of Prescribing During Pregnancy 699
Donald W. Aaronson
This article reviews the current literature and recommendations
pertaining to the safe prescribing of drugs for pregnant allergic
women. Recommendations are made in all of the common catego¬
ries of drugs used for treating pregnant allergic women, detailing
which drugs have sufficient data to allow for use in pregnant
women and which drugs do not have enough data to support
use. Other areas in prescribing, including informed consent, ther¬
apeutic interchange, and legibility issues also are reviewed.
Outcomes of Pregnancy in Asthmatic Women 715
Michael Schatz and Mitchell Dombrowski
This article explores in detail the most commonly reported preg¬
nancy outcomes in asthmatic women. For each adverse outcome,
general information is presented regarding its definition, normal
frequency, major risk factors, and clinical significance regarding
subsequent infant morbidity and mortality. The specific observa¬
tions that have been made regarding the outcome in asthmatic
versus control women are reviewed. Finally, for each outcome,
proposed mechanisms and the data supporting them are de¬
scribed.
The Effect of Pregnancy on the Course of Asthma 729
Joan C. Gluck and Paul A. Gluck
The course of asthma is affected by pregnancy in variable ways.
Overall, a similar number of women improve, worsen, or remain
unchanged in their symptoms during pregnancy. Severe asthma¬
tics have increased symptoms more often than mild asthmatics.
viii contents
The most common time for increased difficulty is the second and
third trimester, especially the sixth month, with improvement in
the last 4 weeks. Asthma is usually not a problem during labor
and delivery and tends to return to the prepregnancy state 3
months after delivery.
The Diagnosis and Management of Asthma During
Pregnancy 745
Allan T. Luskin and Myron A. Lipkowitz
Asthma is the most common potentially serious disorder to com¬
plicate pregnancy. The multiple other causes of dyspnea of preg¬
nancy make diagnosis more difficult. When inadequately man¬
aged, asthma may result in serious consequences for both fetus
and mother. Aggressive management, including education and
communication, environmental control, pharmacotherapy, immu
notherapy, and close monitoring, facilitates a normal outcome of
the pregnancy.
The Management of Severe Asthma During Pregnancy 763
Paul A. Greenberger
Asthma during pregnancy may become severe enough to warrant
the use of oral corticosteroids and high dose beclomethasone
dipropionate or budesonide for treatment. These medications are
not considered teratogenic. During the acute episode of asthma
during pregnancy, oxygen desaturation may occur and may not
be appreciated by the gravida. An important goal of therapy is
to gain control of asthma to avoid continued wheezing dyspnea,
emergency department care, and hospitalization.
Respiratory Failure in Pregnancy 775
Val Catanzarite and Larry Cousins
Respiratory failure can occur during pregnancy or after delivery
from a wide variety of causes. Successful outcomes depend on
understanding the causative disease process, appreciating the
respiratory changes of pregnancy, and recognizing the relation¬
ships of fetal and maternal physiology. This article provides a
review of the physiology of oxygen delivery to the fetus and
discusses diagnostic and management issues.
The Diagnosis and Treatment of Rhinosinusitis During
Pregnancy and Lactation 807
Gary A. Incaudo
Rhinosinusitis in pregnancy represents a challenge to the physi¬
cian both in terms of its diagnosis and therapy. Although there
are several unique influences of pregnancy that adversely affect
contents **
nasal mucosa, there is growing recognition that most sympto¬
matic nasal problems are, in fact, expressions of diagnostic entities
that have been or can be experienced by the patient in the non
pregnant state. In approaching gestational rhinosinusitis, empha¬
sis should be placed on making an early, accurate diagnosis so
that limited, specific, and informed medicinal intervention can
be used.
Anaphylaxis in Pregnancy 831
Tammy L. Heinly and Phil Lieberman
One of the most typical patients presenting for an allergy evalua¬
tion is a female between the ages of 20 and 35. For these women,
childbearing is an issue. To serve the needs of this population
physicians must be well versed in the care of allergic diseases in
the pregnant female. Anaphylaxis has been associated with ma¬
ternal and fetal loss, as well as poor fetal neurologic outcomes.
There are many conditions that may mimic anaphylaxis in preg¬
nancy, however. The intent of this article is to heighten awareness
of the differential diagnosis of such conditions and promote
prompt and effective therapy.
Diagnosis and Treatment of Atopic Dermatitis, Urticaria,
and Angioedema During Pregnancy 839
Susan Boiko and Robert Zeiger
Evaluating a pregnant woman with cutaneous disease raises two
questions: Is the diagnosis related to or independent of the gravid
state? Will treatment intended to relieve the mother s symptoms
affect the developing fetus? This article discusses atopic derma¬
titis, urticaria, and hereditary angioedema as three major causes
of cutaneous disease in pregnancy and describes safe and effec¬
tive treatment for these conditions.
Cumulative Index 857
Subscription Information Inside back cover
x CONTENTS
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| spelling | Asthma and allergy during pregnancy Michael Schatz, guest ed. Philadelphia [u.a.] Saunders 2000 XIV S., S. 663 - 878 graph. Darst. txt rdacontent n rdamedia nc rdacarrier Immunology and allergy clinics of North America 20,4 Asthme Grossesse Asthma in pregnancy Bronchialasthma (DE-588)4069674-1 gnd rswk-swf Schwangerschaft (DE-588)4053724-9 gnd rswk-swf Allergie (DE-588)4001257-8 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Schwangerschaft (DE-588)4053724-9 s Allergie (DE-588)4001257-8 s DE-604 Bronchialasthma (DE-588)4069674-1 s Schatz, Michael Sonstige oth Immunology and allergy clinics of North America 20,4 (DE-604)BV000645505 20,4 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=009155553&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
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