How can a 35-year-old pregnant woman treat allergies safely?

Question

Hello doctor,

I am 35 years old and currently 20 weeks pregnant. I have had dust and weather-related allergies for the past two years, especially during the winter months. This causes a lot of cough, and sometimes I also get a headache on the left side. Earlier, I used to take the FB MDI inhaler. Now, I am using the Asthalin inhaler twice a day.

In my level II 18-week scan, an issue was reported: high-resistance flow in the right uterine artery with a high mean uterine artery PI. The blood flow is not going correctly.

Can you please suggest which inhaler is effective and safe during pregnancy?

Any guidance for a safe pregnancy without breathing issues would be helpful.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

At 20 weeks of pregnancy, dust and weather-change allergies often worsen, especially in winter. Asthalin (Salbutamol) is safe in pregnancy and works quickly, but it only provides short-term relief. It does not address the underlying airway inflammation, so symptoms tend to recur if it is relied upon alone.

For long-term control, we typically require an inhaler that manages both muscle tightness and inflammation.

I recommend a combination of Budesonide with Formoterol (MDI or metered dose inhaler) (400/6), administered as two puffs twice daily, and using the same inhaler for one puff whenever symptoms occur in between, up to six times. Use a spacer along with your MDI inhaler. Correct technique is essential, so please watch an online video to learn it properly.

Your uterine artery Doppler finding means your obstetrician will keep a closer watch on blood flow and fetal growth, but it does not change the choice of asthma medicines. In fact, stable asthma (a chronic lung disease causing inflammation and narrowing of the airways) helps maintain good oxygen delivery to the baby, which is particularly important during pregnancy, when uterine artery resistance is often noted.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.