H1N1 Influenza in Pregnancy: Cause for Concern

Saleeby, Erin; Chapman, Jocelyn; Morse, Jessica E.; Bryant, Allison

doi:10.1097/aog.0b013e3181c8adf1

Cited by 8 publications

(15 citation statements)

References 3 publications

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“…This report summarises the clinical and demographic characteristics of pregnant and postpartum women who died as a result of pandemic H1N1 influenza virus infection in Turkey. The severity of influenza in this case series is consistent with the increased risk of severe disease among pregnant women that has been documented for seasonal influenza epidemics and previous pandemics 5,8,12–16 . Although an association between severe illness and pregnancy is well documented for seasonal influenza, deaths among pregnant women as a result of seasonal influenza appear to be uncommon 7 .…”

Section: Discussionsupporting

confidence: 82%

Maternal deaths associated with H1N1 influenza virus infection in Turkey: a whole-of-population report

Dede

Çelen

Bilgin

et al. 2011

BJOG: An International Journal of Obstetrics &Amp; Gynaecology

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Please cite this paper as: Dede F, Celen S, Bilgin S, Ure G, Ozcan A, Buzgan T, Kose R. Maternal deaths associated with H1N1 influenza virus infection in Turkey: a whole‐of‐population report. BJOG 2011; DOI: 10.1111/j.1471‐0528.2011.03002.x. Objective To review the clinical and demographic characteristics of pregnant and postpartum women who died as a consequence of influenza A H1N1 (2009) infection in Turkey. Design A review of the records for pregnant and postpartum women who died as a consequence of H1N1 influenza virus infection. Setting Nationwide in Turkey. Population Thirty‐six pregnant or postpartum women who died as a result of confirmed pandemic H1N1 influenza virus infection. Methods Using the General Directorate of Mother and Child Health and Family Planning (MCHFP) Registry of the Ministry of Health of Turkey, we identified all pregnant and postpartum women who died as a result of confirmed influenza A H1N1 (2009) infection between 29 October and 31 December 2009. Main outcome measure Maternal mortality as a result of H1N1 virus infection. Results The average time from symptom onset to initial presentation for health care was approximately 2.5 days, and the mean time from symptom onset to the receipt of antiviral medication was approximately 5.5 days. Only one‐fifth of all women received early antiviral treatment (administered 2 days or less after symptom onset) and only one woman was vaccinated for H1N1 influenza 1 week before the onset of symptoms. The cause‐specific maternal mortality ratio for H1N1 influenza infection in Turkey was estimated to be 3.01. The calculated risk of death associated with H1N1 influenza virus infection was approximately four times higher in pregnant and postpartum women than in the general population (relative risk, 3.88; 95% confidence interval, 2.77–5.43). Conclusions Pregnant women are at increased risk for complications of, and death from, H1N1 influenza infection. Prompt evaluation and antiviral treatment of influenza‐like illness should be considered in such women. Vaccination for H1N1 influenza may reduce the total number of deaths in pregnant and postpartum women. The high cause‐specific maternal mortality rate suggests that H1N1 influenza virus infection may have increased the 2009 maternal mortality ratio in Turkey.

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Section: Discussionsupporting

confidence: 82%

Maternal deaths associated with H1N1 influenza virus infection in Turkey: a whole-of-population report

Dede

Çelen

Bilgin

et al. 2011

BJOG: An International Journal of Obstetrics &Amp; Gynaecology

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“…3,5,8,9 The principal clinical syndrome leading to hospitalization in intensive care unit is diffuse viral pneumonitis associated with hypoxemia, ARDS, sometimes shock and renal failure. 4,9 None of our patients presented with symptoms of severe disease and were not admitted to intensive care unit.…”

Section: Discussionmentioning

confidence: 99%

H1N1 Influenza Virus Infection in Pregnancy: A Study of 32 Cases

Prabhu¹,

Malhotra²

2014

Journal of South Asian Federation of Obstetrics and Gynaecology

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Reports from the past pandemics (1918)(1919) and the 2009 outbreak have shown that pregnant mothers are at risk of complications from the H1N1 influenza virus infection. This study was undertaken to analyze the clinical course of H1N1 infection in pregnancy, the maternal and perinatal outcome and the treatment efficacy of oseltamivir in H1N1 infected mothers. This is a descriptive study from the Institute of Obstetrics and Gynaecology and the case series were collected from September 2009 to December 2010. Influenza like illness (ILI) was suspected in 207 pregnant women, and the 32 cases who were positive for H1N1 influenza infection by RT PCR test were taken for this study. 90.6% were in the age group between 21 and 29 years of age and 34.4% were multigravid women. The most common presenting symptoms were fever and cough. Co-morbid conditions such as gestational hypertension, bronchial asthma and others were seen in 9 cases. In 53% of cases treatment was initiated with oseltamivir within 48 hours of onset of symptoms. All the patients recovered completely at the end of 5 days of treatment. There were no maternal or perinatal deaths.

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“…Based on the experience from prior pandemics, pregnant women have an increased morbidity and mortality from influenza infections [9]. Changes in pulmonary physiology and a relative immune suppression during pregnancy may contribute to the increased susceptibility to pulmonary complications [10]. With the increase in the incidence and complications of Swine-origin Influenza A (H1N1) Virus [11], it is imperative to have a high index of suspicion for this virus.…”

Section: Discussionmentioning

confidence: 99%

The use of high-frequency oscillatory ventilation in a patient with H1N1 pneumonia

Netteburg

Bsat

Healy

et al. 2010

The Journal of Maternal-Fetal & Neonatal Medicine

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A 32-year-old multigravida was admitted at 33.9 weeks with respiratory distress. Community-acquired pneumonia was suspected and antimicrobial treatment initiated with ceftriaxone sodium and azithromycin. However, despite these therapies her respiratory status deteriorated. She was subsequently diagnosed with Swine-origin Influenza A (H1N1) Virus pneumonia and treated with oseltamivir. After failing conventional ventilation, high-frequency oscillatory ventilation (HFOV) was utilized. In pregnant patients who fail to respond to conventional ventilation techniques, HFOV should be considered.

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H1N1 Influenza in Pregnancy: Cause for Concern

Cited by 8 publications

References 3 publications

Maternal deaths associated with H1N1 influenza virus infection in Turkey: a whole-of-population report

Maternal deaths associated with H1N1 influenza virus infection in Turkey: a whole-of-population report

H1N1 Influenza Virus Infection in Pregnancy: A Study of 32 Cases

The use of high-frequency oscillatory ventilation in a patient with H1N1 pneumonia

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