Acute Asthma Attack in Pregnancy Treatment

Call 911

1. Symptoms of an acute asthma attack in pregnancy include:

• Shortness of breath
• Wheezing with fluids or mucus.
• Difficulty talking, walking, or thinking because of shortness of breath
• Neck and ribs moving in during breathing
• Blue- or gray-looking skin
• Peak flow reading below 60% of personal best
• Decrease in fetal kick count if the baby is in distress

2. Follow the Woman’s Asthma Plan, if Possible

• Find out if the woman has an individualized treatment plan for asthma attacks in pregnancy from a healthcare provider. Follow the plan. 
• Give the woman a fast-relief rescue inhaler if they have one.

3. Give Asthma First Aid

If the woman doesn't have an asthma action plan:

• Sit the woman upright comfortably and loosen tight clothing.
• If a woman has asthma medication, such as an inhaler, help them use it.
• If a woman doesn't have an inhaler, use one from a first aid kit or borrow someone else’s. The medication should be a short-acting, rescue inhaler (not the prevention inhalers)--specifically albuterol. In an acute asthma attack, the primary medication used is always the rescue inhaler albuterol either through an inhaler or nebulizer if they have one.

4. Use Inhaler With a Spacer, if Possible

• Remove the cap and shake the inhaler well.
• Insert the inhaler into the spacer.
• Have them breathe out completely and put the mouth tightly around the spacer mouthpiece.
• Press the inhaler once to deliver a puff.
• Have them breathe in slowly through the mouth and then hold breath for 10 seconds.
• Give a total of four puffs, waiting about a minute between each puff.

5. Use Inhaler Without a Spacer, if Necessary

• Remove the cap and shake the inhaler well.
• Have the woman breathe out all the way and seal lips tightly around inhaler mouthpiece.
• As the woman starts to breathe in slowly, press down on the inhaler one time.
• Have them keep breathing in as slowly and deeply as possible (about five to seven seconds) and then hold breath for 10 seconds.
• For a mild to moderate attack, use 2 to 4 inhalations every 20 minutes for 3 doses; for a severe attack use 4 to 10 inhalations every 20 minutes for 3 doses.