Bronchial asthma is a relatively common comorbidity in women during pregnancy. The incidence of asthma during pregnancy has been reported to be about 1%, with persistent asthma occurring in about 0.2%. In women with pre-existing asthma, about 1/3 have worsening, 1/3 have decreasing, and 1/3 have no change in their condition during pregnancy. Among pregnant women with worsening asthma, the most serious condition is during 29-36 weeks of gestation and decreases during the last 4 weeks of pregnancy. The treatment of asthma during pregnancy is the same as that of general asthma, but the pregnant woman is a special individual and treatment should take into account the safety of the mother and child. In the past, clinicians have overemphasized the danger of medication to the fetus during pregnancy and overlooked the adverse effects of asthma on the pregnant woman and the fetus. In fact, the use of medications to control asthma during pregnancy is essential and should be given great attention by clinicians. This presentation briefly introduces the pharmacological treatment of bronchial asthma combined with pregnancy. Adrenal glucocorticoid hormone is the most effective drug for the treatment of asthma, and early application of hormone is recommended for patients with severe asthma. It has been reported that oral or inhaled hormone treatment for asthma in pregnant women can produce good therapeutic effects. (1) Prednisone, also known as prednisone, is classified as Class C by FDA and is the most widely used hormone preparation in clinical practice. According to foreign monitoring data, 236 cases of pregnant women applied prednisone in early pregnancy, and the results showed no significant teratogenic effects on the fetus. Due to the presence of 11-B dehydrogenase in the placenta, most prednisone is inactivated in the placenta and has little effect on the fetus. The daily dose of prednisone equal to or less than 10mg during pregnancy is a more general safe dose. (2) Dexamethasone, also known as flumethasone, is classified as Class C by the FDA. There have been no reports of fetal malformations caused by the application of dexamethasone. Because of the weak inactivation of dexamethasone by 11-B dehydrogenase, dexamethasone is widely used in preterm infants at less than 34 weeks of gestation and has a significant effect on fetal lung maturation. Dexamethasone in pregnant women may inhibit estriol and cortisol production, and the effects of these changes on the fetus have not been studied. (3) Beclomethasone is classified as Class C by FDA. It is a halogenated corticosteroid used for the treatment of chronic bronchial asthma and various types of rhinitis by nebulized inhalation or intranasal spray. Animal experiments have found that this product has teratogenic effects. However, in humans, no teratogenic effect on the fetus has been observed. According to overseas monitoring data, 395 cases of pregnant women who used beclomethasone in the first 3 months of pregnancy were retrospectively analyzed, and no significant teratogenic effects were observed when the newborns were followed. (4) Tretinoin is also known as acetone de-inflammatory pine, de-inflammatory pine, methotrexate, which is classified as Class C by FDA. Tretinoin is a synthetic corticosteroid with strong anti-inflammatory effect. Animal studies have confirmed that tretinoin application in mice and rats can cause cleft palate in fetuses, while malformations of the central nervous system and intrauterine growth retardation can be found in primates. The fetal safety of tretinoin in women during pregnancy is poorly documented. Case reports of severe symmetric intrauterine growth retardation have been reported, and caution is advised because of the high number of adverse effects associated with long-term use of tretinoin. In conclusion, there is no conclusive evidence that the use of hormones in early pregnancy has teratogenic effects on the fetus. However, pregnant women should not apply hormones for a long time and in large doses, otherwise it may lead to overdue pregnancy, intrauterine growth retardation, or even intrauterine stillbirth, and may increase the chance of mother-infant infection. 2.B-adrenergic receptor agonist selectively acts on B2 receptor, which can directly dilate bronchial smooth muscle, increase cilia movement, reduce vascular permeability and inhibit the release of allergic mediators from mast cells and basophils, and is the first-line drug for the treatment of acute bronchial asthma. The routes of administration include inhalation and oral administration. Commonly used drugs are salbutamol, terbutaline, oxybutynin, etc. (1) Salbutamol, also known as albuterol, hydroxy methyl tert-butyl adrenaline, and couchpitol, is classified as Class C by FDA. It is mainly used for the treatment of bronchial asthma, and is more commonly used in obstetric clinics for the treatment of premature birth. Salbutamol can pass through the placenta, animal experiments have shown that: the incidence of cleft palate in fetuses increased in mice with the application of this product, which is positively correlated with the dose. According to foreign monitoring data, the incidence of neonatal polydactyly seems to be increased in 1090 cases of application of this product in the early 3 months of pregnancy, but it cannot be excluded that it is related to the disease of the mother. The use of this product in pregnant women may cause tachycardia and transient hyperglycemia in mothers and infants. Because salbutamol can inhibit uterine contractions and induce postpartum hemorrhage, it should be avoided during labor. (2) Terbutaline, also known as mesalamine, is classified as Class B by the FDA. It was first used to treat asthma and is now also used to treat preterm labor. The drug concentration in the umbilical cord blood is on average 36% of that in the mother’s blood. Animal experiments have not found teratogenic effects of this product. According to overseas monitoring data, no significant teratogenic effect was found in 149 cases of pregnant women who applied this product in early pregnancy. Oral terbutaline, the effect on glucose tolerance of pregnant women is more obvious, but nebulized inhalation can reduce the adverse effects. (3) Oxybutynin is classified as Class C by FDA. This product has two kinds of preparations, oral and inhalation, nebulized inhalation is more widely used, mainly for the treatment of bronchial asthma. There is no report of fetal malformation caused by the application of this product, but according to overseas monitoring data, 361 cases of pregnant women who used this product in early pregnancy showed a slightly higher incidence of polydactyly in their newborns, which cannot be ruled out to be related to the diseases suffered by pregnant women. The use of this product in pregnant women may reveal transient tachycardia, hypotension, and hyperglycemia. In conclusion, B-adrenoceptor agonists are indicated in patients with various degrees of asthma during pregnancy with relatively pronounced effects. The higher doses of oral preparations may cause tachycardia and postpartum hemorrhage in pregnant women. However, treatment by inhalation with a small dose of drugs, direct action on the respiratory tract, systemic adverse reactions are less. 3, theophylline drugs have a moderate diastolic effect on the bronchi, and can improve the function of the diaphragm, prevent respiratory muscle fatigue, and improve the movement of bronchial cilia. Clinically used drugs are theophylline, aminophylline and dihydroxypropyl theophylline. But the efficacy is not as good as ! Adrenergic agonists and hormone inhalation are ideal. They can be given at bedtime to help reduce nocturnal asthma attacks. (1) Theophylline Theophylline is a xanthine drug, classified as Class C by the FDA. It can dilate the bronchial tubes, but also has positive inotropic effects on the myocardium, dilates blood vessels and diuresis, and is mainly used in obstetric clinics for bronchial asthma and obstructive lung disease in pregnancy. There are no reports of fetal malformation. According to foreign monitoring data, 1240 cases of pregnant women using this product in early pregnancy showed that the incidence of neonatal cardiovascular malformation, cleft lip and palate and spina bifida was slightly more, but it cannot be excluded that it is related to the disease suffered by the mother. (2) Aminophylline Aminophylline is a condensation of theophylline and ethylenediamine, which is classified as Class C by FDA. Animal experiments have demonstrated that high doses of intravenous administration of this product in pregnant rats can cause fetal paw-toe deformities, but no fetal finger-toe deformities have been found in human pregnancies. It is generally believed that within the therapeutic dose range, it will not cause serious adverse reactions in the fetus. However, excessive doses of this product administered within 6 hours before delivery may cause neonatal agitation and tachycardia, and in severe cases, vomiting and keratoconus may occur. Intravenous injection of this product during labor may cause weak contraction of the uterus and should be noted. (3) Dihydroxypropyl theophylline, also known as asthma, is a xanthine drug, classified as Class C by FDA. Its action and use is similar to aminophylline, which can be taken orally, intramuscularly and intravenously. According to foreign monitoring data, 97 cases of pregnant women applied this product in early pregnancy, the results show that the incidence of cardiovascular malformations in their newborns is slightly higher, and it is not excluded that it is related to the disease suffered by the mother. 4.Sodium cromoglycate is a non-corticosteroid anti-inflammatory agent, which is classified as Class B by FDA. It does not directly relax bronchial smooth muscle, but has an inhibitory effect on both immediate and delayed asthmatic reactions caused by exposure to various allergens. The main mechanism may be the inhibition of mast cell release mediators, and is generally used in patients with chronic asthma. The product is poorly absorbed orally and is usually inhaled by spray. It is more effective as prevention of asthma attacks before delivery or exposure to allergens. No teratogenic effect has been found in animal experiments, and it is safe for the fetus when applied to pregnant women. It has been reported that 296 cases of pregnant women applied this product during pregnancy, no significant teratogenic effect was observed. M cholinergic receptor antagonists can inhibit asthma attacks caused by agitation of airway cholinergic nerve endings by physicochemical factors, and are also suitable for asthma attacks caused by agitation of the vagus nerve by mental stress and childbirth exertion. Commonly used preparations are atropine or ipratropium bromide aerosols. (1) Atropine is classified as Class C by FDA and has a wide range of clinical uses. It is mainly used in obstetric clinics for preanesthetic administration for surgery and stress testing of the fetus. Nebulized inhalation can increase fetal heart rate by 10-35 beats/min within 2-15 minutes by depressing the fetal vagus nerve. In humans, no teratogenic effect of this product has been found. According to foreign monitoring data, 381 cases of pregnant women used this product in early pregnancy, no significant teratogenic effect was seen. (2) Ipratropium bromide is classified as Class B by FDA. It has higher selective diastolic effect on bronchial smooth muscle and less adverse effects than atropine, so it is safer and more effective. No teratogenic effect of this product has been found in animal experiments. In humans, did not see this product significantly teratogenic reports. 6, magnesium sulfate FDA classified as A, B2 adrenoceptor agonist treatment is invalid for moderate and severe asthma attacks can be intravenous magnesium sulfate injection. Pregnancy using magnesium sulfate has a history of sixty or seventy years, a large number of clinical practice to prove that magnesium sulfate treatment of child A is safe and effective, still for the prevention and treatment of child A drug of choice. Pregnant women intravenous injection of magnesium sulfate, the concentration of magnesium ions in the umbilical cord blood is similar to that in the mother’s blood. Fetal hypomagnesemia can slow down the fetal heart rate and abnormal biophysical scores. Neonates with hypomagnesemia may have respiratory depression and hypotonia. Long-term application of this product in pregnant women can make the fetus hypocalcemia, serious cases can cause congenital rickets. Asthma patients apply the general therapeutic dose of anti-asthma drugs during breastfeeding, the drug content in breast milk rarely exceeds 1% of the maternal dose, and only part of it is absorbed by the breastfed child, so it usually does not cause obvious danger to the breastfed child. Prednisone is only a trace amount in breast milk and can be used during breastfeeding. Dexamethasone, beclomethasone, and tretinoin are not known to be lactated and are recommended for use with caution in nursing women. Salbutamol, terbutaline, and oxybutynin can be used during breastfeeding. Theophylline, aminophylline, and dihydroxypropyl theophylline can also be used during lactation and continue to be used for lactation. It is not known whether sodium cromoglycate is incorporated into breast milk, but it is absorbed very little through the intestinal tract of the breast, so it can continue to be used for breastfeeding after delivery. Atropine, ipratropium bromide into the milk is not known, but the American Academy of Pediatrics believes that lactating mothers can continue to breastfeed with the application of this product. Intravenous injection of magnesium sulfate milk magnesium ion content can be increased, but no harm to the breast, can breastfeeding.