The care offered to pregnant women with asthma at the Copenhagen University Hospital – Hvidovre, Copenhagen, Denmark:
- All pregnant women referred to give birth at the hospital (approximately 7500/year) receive an invitation to send an e-mail to astmaoggraviditet@regionh.dk if they have asthma and/or allergy.
- All responders are given a scheduled appointment at the respiratory outpatient clinic.
- The outpatient visit comprises case history, including symptoms and prescribed medication, spirometry and FeNO.
- All women with known asthma and/or asthma-like symptoms are given scheduled follow-up visits approximately every 4 weeks throughout pregnancy (and 3 months post partum).
- Unscheduled visits at the outpatient clinic are planned if necessary.
Assessment of symptoms (using the Asthma Control Questionnaire, ACQ), use of rescue medication, adherence with controller medication, device technique, adjustment of treatment if necessary, spirometry and FeNO are repeated at all visits to the respiratory outpatient clinic.
All pregnant women with asthma, irrespective of the severity, are offered being part of the monitoring of asthma during pregnancy program (MAP).
At the post partum visit, earlier if necessary, the women are referred for further diagnostic work-up (not least if the asthma diagnosis has not previously been verified objectively), allergy tests, assessment of possible severe asthma (highly specialised severe asthma clinic part of the respiratory outpatient clinic) etc. if required.
The primary focus is best possible asthma control during pregnancy, based on team-work between the woman and the health care providers.
The Hvidovre MAP-program has close collaboration, including teaching, with the obstetric team, and pregnant women not responding to the initial invitation may be referred directly to the MAP-program at any time during pregnancy (submission of an electronic referral form). The referral forms are triaged by the head of the MAP-program.