Hi,

Thanks for posting your query on XXXXXXX

After going through your history, I would like to comment the following:

1. You seem to be diagnosed case of asthma and you are currently in the 5th month of your pregnancy.

2. Regarding asthma in pregnancy, I would like you to know that the asthma course is totally unpredictable in pregnancy as 1/3rd cases improve, 1/3rd cases remain as it is and 1/3rd cases deteriorate.

3. A strict control of your asthma is absolutely essential in pregnancy.

4. Flomist spray (fluticasone nasal spray) is used to control allergic rhinitis which is frequently accompanied with asthma. Allergic rhinitis needs to be controlled for a proper control of asthma.

5. In fact for proper asthma control fluticasone is given by inhaled route in combimation with a bronchodilator inhaler.

6. You should not worry about the safety in pregnancy as till date no adverse outcome on pregnancy has been reported by fluticasone nasal spray. the dose of fluticasone is in micrograms! (each spray gives 50 micrograms of the drug) whereas the conventional oral drugs have their doses in miligrams! Also it is the 1st trimester where the risk to the fetus is maximum since it is the period of organogenesis.

7. Coming to your asthma , I would strongly suggest you to consult a Pulmonologist and immediately shift to daily inhaler therapy (of maintenance inhaler) based on your clinical assessment. Ventolin is a reliever medicine to be used in attacks of breathlessness and in pregnancy you should also be on maintenance inhalers (combination of bronchodilator and inhaled corticosteroid) to prevent any asthmatic attack in pregnancy as that might adversely affect the course of pregnancy.

I hope I have answered your query. Please accept my answer if you have no follow up queries. I will be glad to answer any follow up queries.

Wish you good health.

Take care.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB

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