Author Archives: Jackie Aim

What is spirometry?

Female patient with clinician in hospital room

Spirometry is:

A test to show how your lungs are working.
One of the first tests which may be carried out to investigate any respiratory symptoms such as shortness of breath, cough or wheeze.
Used to show if you have a lung disease.
Used to help to separate patients with asthma from those with COPD. The test can show if your narrowing of your airways is reversible or not. This is done before and after taking medication by inhaler.
Used to measure how much air can be quickly blown out of your lungs in 1 second (this is called your FEV1 or Forced Expiratory Volume 1).
Used to measure the full amount of air that can be breathed out FVC or Forced Vital Capacity. (There will always be a small amount of air which remains in your lungs to prevent them from collapsing).

After your baby has arrived

Being a new mum is a hectic time for anyone. Your body needs time to recover. Keep your asthma in control for you and your new baby.

If your asthma symptoms have been better than usual during your pregnancy, you may find your asthma starts to return to the way it was before your pregnancy. You may need some extra advice about this from your doctor or asthma nurse. It may take a while until symptoms are stable again.

If you are breast feeding your baby it is safe to take your usual asthma inhalers and medicines as normal.

During labour

Woman in labour

If your asthma is well controlled there is little or no increased risk for you or your baby.

Make sure you take your inhalers and asthma medication with you if you are admitted to hospital for the birth.

Normal methods of pain control during birth are safe to be given to women with asthma. You can discuss this with your midwife.

An epidural (anaesthetic injection around the spine) is sometimes preferred for pain control as it places less stress on breathing during labour.

If you do need to have a general anaesthetic for a caesarean delivery the doctors, nurses and anaesthetist will know about your asthma and can take appropriate precautions during the delivery.

If you have severe asthma during pregnancy

You, your asthma team and your midwifery team should work together to help you during your pregnancy.

You may need additional check ups such as lung function tests, spirometry or peak flow tests. You may also be offered additional checks for your baby such as ultrasound scans and checks for your baby’s movements and position.

You maybe given increased dose of asthma inhalers or medications. This is the safer option for you and your baby over the increased risk of complications from your asthma on your preganacy. If you have any questions or concerns speak to your doctor, midwife or asthma nurse. Let all your healthcare professionals know about any changes in your asthma or in your pregnancy.

if you have a severe asthma attack you may require drugs which may be given by a nebuliser. Very occasionally the attack may be severe and result in a hospital admission and you may be given some oxygen in addition to all your normal medication.

A healthy pregnancy

In order to develop a positive self-management approach to your pregnancy you should follow all the health messages from your midwife and ante natal team:

Avoid smoking or being around those who smoke Smoking makes an asthma attack more likely and an asthma attack can stress your baby. Smoking increases the chance of miscarriage, your baby may be born with breathing problems or may be premature with a low birth weight. You can get special help if you want to quit while pregnant.
Avoid your known asthma triggers.
Eat a healthy, balanced diet and avoid putting on lots of excess weight. There is no evidence that avoiding certain foods when pregnant prevents your baby from developing asthma. You should only avoid foods which you yourself have allergies to or the same foods all pregnant women should avoid such as unpasteurised cheese, raw fish, undercooked meat and so on. You can keep a check on your weight when seeing your midwife.
Avoid alcohol (excessive exposure to alcohol can cause damage to your unborn baby at all stages of pregnancy). reference NHS Inform Ready Steady Baby
Drink plenty of water and soft sugar free drinks to keep hydrated.
Attend ante natal classes. They are important to monitor the health of you and your baby throughout the pregnancy.

Other medicines

If you have allergies such as hay fever there are some antihistamines which are suitable for asthma and pregnancy – speak to your doctor about this.

During pregnancy indigestion, heartburn and acid reflux are common (when stomach acid is pushed up in to your throat, irritating your airways and feeding tube or oesophagus) This acid reflux can make your asthma worse. Ask your doctor or midwife about the best tips and the most suitable treatment for you.

Remember it is safe to receive your annual flu vaccination to protect you and your baby and you should make sure you attend to have this.

If you have any concerns you can ask for an early asthma review even if it was less than a year since your last review.

Your asthma medicine during pregnancy

Blue inhaler

You should manage your asthma in the same way as usual during pregnancy. Your inhalers are safe for you and are not know to harm your baby.

You can increase your dose of inhaler as indicated in your asthma plan if you start to feel more breathless. For example you may need to increase the dose of your preventer inhaler if you feel a cold coming on. You should make a check up appointment with your doctor.

If you need a steroid course while you are pregnant, this is also safe and will not harm your baby.

If you have any concerns about your asthma medicines see your doctor before you stop any medicines. You should also check before you buy any over the counter medicines.

Taking care of you and your baby

The most important thing you can do, when pregnant, is to continue to control your own asthma health by following your asthma plan. If you don’t have an asthma plan see your doctor to discuss and tailor one for your needs.

It is important that you continue to take all of your prescribed medicines including your preventer, reliever and long acting inhalers. All of these are safe to use throughout your pregnancy.

Information

Remember if you stop taking your asthma medicines you could be putting yourself at risk from an asthma attack and your baby would be at much greater risk in the womb. If this happens your baby risks being born prematurely with a low birth weight.

Self management

You are taking in oxygen for you and your baby so it is so important that you have good control of your asthma for both of you.

Examples of asthma action plans:

How does pregnancy affect asthma?

Pregnant woman

The information in this section may be useful if you are pregnant or are planning a pregnancy.

It is not possible to predict how your asthma will react when you are pregnant but studies have shown that:

One third of women with asthma actually have improved symptoms while pregnant.
One third will have no change in their asthma.
One third will report some worsening of their asthma symptoms, most commonly between 24 to 36 weeks of pregnancy.

If you have severe asthma it is more likely to worsen during pregnancy that for those women with mild asthma.

However it is very rare for women to have asthma symptoms during labour and birth as your body produces natural hormones, cortisone and adrenalin which help to protect you and your baby.

Other tests

There are some tests which can be done at your GP surgery such as:

Peak flow monitoring.
Simple spirometry.

Some more detailed tests are done in hospital outpatient’s respiratory departments. These may include:

More detailed spirometry.
Exercise tests.
Gas transfer tests.

You can find out more about these in the next section.