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DISORDERS IN PREGNANCY

RESPIRATORY DISORDERS

- Range from mild (common cold) to severe


(pneumonia) to chronic (tuberculosis or COPD)
A Woman with Acute Nasopharyngitis

- Common cold tends to be more severe during


pregnancy than at other times because during
pregnancy, estrogen stimulation normally causes
some degree of nasal congestion.
Management:

• Aspirin should be avoided


• Antibiotic therapy is unnecessary except to prevent
secondary infection
A Woman with Influenza

- spread in epidemic form accompanied by:


> high fever
> extreme prostration
> aching pains in the back and extremities
> sore, raw throat
Management:

• Antipyretic
• Oral antiviral drug ( category C)
• Flu vaccine
A Woman with Pneumonia

• Is the bacterial or viral invasion of lung tissue by


pathogens:

- S. pneumonia
- Haemophilus influenzae
- Mycoplasma pneumonia
Management:

• Antibiotic therapy
• Oxygen therapy
• Ventilation support ( severe case)
A Woman with Asthma

• Asthma is a disorder marked by reversible:

- airflow obstruction
- airway hyperactivity
- airway inflammation
• Symptoms are often triggered by an inhaled allergen
such as pollen or cigarette smoke.

With inhalation of allergen:

1.there is an immediate release of bioactive mediators


such as histamine and leukotrienes from an
IgE/immunoglobulin interaction.
2.This results in constriction of the bronchial smooth
muscle, marked mucosal inflammation and swelling
and the production of thick bronchial secretions.

These 3 processes cause a marked reduction in the size of


the lumen of air passages.
Common Drug of Choice:
• Inhaler
- corticosteroids beclomethasone
(Beclovent, Vancenase)

- budesonide
( Pulmicort, Rhinocort)

• Parenteral administration of hydrocortisone

• Beta - adrenergic agonists


( Terbutaline, Albuterol)
A Woman with Tuberculosis

Mycobacterium Tuberculosis,
an acid fast bacillus invades the
lung tissue

macrophages and T
lymphocytes surround the
invading bacillus

Fibrosis, calcification and a


final ring of collagenous scar
tissue develop
Assessment

• In high- risk areas:


- undergo PPD test at their first pre-natal visit

( + ) , chest X-ray is scheduled to confirm the


diagnosis , this can be done safely during
pregnancy if the woman’s abdomen is shielded
Symptoms:

• Chronic cough
• Weight loss
• Hemoptysis
• Night sweats
• Low-grade fever
• Chronic fatigue
Therapeutic Management

• Active TB
Drug of Choice:
Isoniazid (INH)
Ethambutol HCl

- may be given without apparent teratogenic


effects during pregnancy
A woman who had TB earlier in life

• Must be especially careful to maintain an


adequate level of calcium during pregnancy to
ensure that tuberculosis pockets are not broken
down.

• A woman is usually advised to wait 1 to 2 years


after the infection becomes inactive before
attempting to conceive
If Active TB is in the home:
• Infant
- is on prophylactic INH to prevent infection
- follow-up skin test at 3-month interval

• Mother
- if on INH, should not breastfeed ( or the
infant’s dosage should be reduced)
A woman with COPD
• Constrictive air disease limits the amount of
oxygen that can reach the lungs so women may
need additional rest because of fatigue and
continuous supplemental oxygen.

“AVOID PREGNANCY”