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Asthma in pregnancy — SCE Respiratory MCQ

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ModerateAsthmaAsthma in pregnancySCE Respiratory

A 31-year-old woman at 22 weeks' gestation has asthma controlled on low-dose budesonide/formoterol MART. She asks whether she should stop inhaled corticosteroid because of fetal risk. She has had one previous severe asthma attack requiring intensive care. What is the most appropriate management?

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Correct answer: C — Continue inhaled corticosteroid-containing therapy and optimise an asthma action plan

Good asthma control in pregnancy is safer for mother and fetus than withdrawing effective ICS-containing treatment. SABA monotherapy or stopping ICS increases the risk of exacerbation, and maintenance oral prednisolone is not a safer routine substitute. Pregnancy should prompt inhaler technique review, trigger management and a written action plan rather than therapeutic de-escalation.

Reference: BTS/NICE/SIGN Asthma Guideline NG245; BNF