Patient: In 2004, my wife suffered from asthma with attacks of dyspnea and itchy ears, nose and throat. The sputum was white and foamy, and the amount was high. Laboratory tests, 2005, 2006, 2007 and 2008 were seen at the respiratory department of China Medical University in Shenyang. In the first two years, I thought it was respiratory hyperresponsiveness, but in April 2008, I thought it was asthma. I have used many kinds of medications before, but since April 21, 2008, I have been taking Sulidex (50 micrograms/250 micrograms) once in the morning and once in the evening, and I have been using co-codone for rhinitis (GlaxoSmithKline’s drug containing fluticasone propionate) and subcutaneous injection of Hunan Jiuzhitang Skikang BCG Polysaccharide Ribonucleic Acid Injection. The effect was obvious and no asthma symptoms appeared. I conceived around May 14 of this year and found out I was pregnant on June 11. My wife has had two miscarriages of her own accord. Can I ask the doctor if I can keep the baby and if there will be any problems? Thank you very much! Zhang Qi, Department of Respiratory Medicine, Jiaxing First Hospital
Jiaxing First Hospital Respiratory Department Zhang Qi: Personally, I think we should keep the baby. I have a history of two miscarriages in the past, have you been to the obstetrics and gynecology department to find out the cause? Currently you are using Sulidex (50 mcg/250 mcg) once in the morning and once in the evening and co-codone without nasal and asthma symptoms appear, continue to adhere to until the symptoms are stable for 3 months after step-down treatment, the earliest is August, can be changed to Sulidex 50/100 or Shinbikdub 80ug/4.5ug, co-codone can be considered for seasonal use according to symptoms, BCG polysaccharide nucleic acid injection can be discontinued. It is recommended to keep an asthma diary to facilitate communication with your doctor. Purely from the perspective of asthma, as long as the condition is well controlled during pregnancy, there is little effect on the fetus, and the hormone inhalation method is correct and the mouth is carefully rinsed, there will be no effect on the fetus. However, asthma is not the only factor that affects the health of the fetus.
Patient: I have suffered from asthma since 2004. She has difficulty breathing and has white, foamy sputum during the attack. She has been seeing a doctor since 2005. Since April 21, 2008, I have been using Sulforaphane (50 mcg/250 mcg), colecalciferol, and Stryker. The effect is obvious, no symptoms appear June 11 checkup, said to be about 30 days pregnant. I have read your article and would like to ask if I can keep this baby.
Patient: Thank you for your prompt reply. I have read some information that the use of glucocorticoids in the first trimester of pregnancy may produce malformations. I am worried about the effect of continuing the medication on the baby, so I have stopped taking the medication for three days now, and I wonder if I should continue it.
Zhang Qi, Department of Respiratory Medicine, Jiaxing First Hospital: The main reason for using glucocorticoids in the first trimester of pregnancy is the systemic application of larger doses, such as autoimmune diseases where the dosage of oral hormones is larger, which is not suitable for pregnancy, but the safety of inhaled hormones is still very high, but it is impossible to write on the manual how much is safe for pregnant women, because it is against ethics to conduct clinical studies on pregnant women. It is still recommended to treat asthma regularly, because asthma attacks can also affect the fetus, which can lead to preterm birth, stunting, growth retardation, overdue birth, low birth weight babies; for pregnant women, it can cause pre-eclampsia, pregnancy hypertension, pregnancy toxemia, vaginal bleeding and obstructed labor. Severe asthma attacks can even endanger the life of the pregnant woman and the fetus.
Patient: My wife says she has no psychological burden now. Thank you for your guidance. If the little one born is healthy, we will definitely go to thank you specially!!! I would like to keep in touch with you so that I can consult you at any time and ask for your guidance, is there any way to do so?
Jiaxing First Hospital respiratory department Zhang Qi: good, Jiangnan water town is very beautiful, welcome!
Patients: You and your family are welcome to come to the Northeast to ski. We have a ski resort here.
Jiaxing First Hospital Respiratory Department Zhang Qi: definitely come when you have time
Patient: Dr. Zhang, my wife has not been using Sulidex since June 13, and now she is a bit stuffy, but not out of breath. She has been sticking with Skidmore. What should we do now? What medication should we use or not use?
Jiaxing First Hospital Respiratory Department Zhang Qi: You stopped using Sulidex for less than 2 months? Now you can go to the hospital to measure the lung function, conditions to do induced sputum eosinophil count, or buy a peak velocity monitor, according to the ACT score, such as both suggest that not fully controlled should continue to use inhaled hormone or ICS + LABA combination therapy