FATAL PROGNOSIS OF H1N1 INFLUENZA IN LATE TRIMESTER OF PREGNANCY: DESCRIPTIVE ANALYSIS OF FOUR CASES (original) (raw)
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H1N1 infection in Pregnancy: clinical course in two women
Journal of the Turkish German Gynecological Association, 2011
Pregnant women are one of the major risk groups for disease related morbidity and mortality from influenza A (H1N1, swine flu) pandemic. Healthy pregnant women are supposed to have 4 to 5 fold increased rate of serious illness and hospitalization compared to non-pregnant subjects. Herein, the clinical course of novel influenza A (H1N1) infection in two pregnant women was presented. One woman expired due to delay in treatment, while the other one was discharged on day six after prompt treatment. We would like to emphasize that obstetricians should be aware of the clinical and radiological manifestations of influenza A for prompt diagnosis and treatment. Obstetricians also should prepare themselves to provide adequate care for pregnancy related complications encountered by pregnant women with H1N1 infection. (J Turkish-German Gynecol Assoc 2011; 12: 118-20)
2012
Pregnant and postpartum women are considered a population at increased risk of hospitalization of H1N1 infection. We report the case of a young postpartum woman, who developed evidence of respiratory failure reaching the point of requiring intubation due to an H1N1 influenza virus infection two days after a caesarean delivery. We emphasize the diagnosis, management, and the outcome focusing on the question "what the care providers, including obstetric health care workers, ought to know?" Diagnostic and management strategy for pregnant or postpartum women with novel influenza A (H1N1) viral infection and increased awareness amongst patients and health care professionals may result in improved survival.
A Pregnant Case with Severe Influenza A (H1N1) Virus Infection-Related ARDS
European Journal of General Medicine, 2011
Pregnant women are more susceptible to influenza and pregnancy may enhance the severity of the illness. In this article, we reported a 37-year-old pregnant woman with ARDS related to severe influenza A (H1N1) virus infection. A 37-year-old pregnant woman at 36 weeks gestation was admitted to our ICU with rapidly worsening dyspnoea. She had tachycardia, tachypnoea and severe hypoxia (PaO2/FiO2=104). A diagnosis severe H1N1 infection-related ARDS was made and treated with oseltamivir, broad-spectrum antibiotics, bronchodilators and NIV. Her nasopharyngeal swab was positive for H1N1. One day later, her hypoxia remained severe, and she was intubated and MV was commenced. Simultaneously, the patient gave birth to a healthy boy by emergency cesarean delivery. Her condition gradually improved. Pregnant women with severe H1N1 infection-related ARDS may be successfully treated with oseltamivir and mechanical ventilation.
Influenza A Viral Infection with Septic Shock in Pregnancy
Case Reports in Obstetrics and Gynecology, 2019
The influenza virus is RNA virus and is classified into four subtypes, influenza A, influenza B, influenza C, and influenza D. One of the subtypes of influenza A, the H1N1 strain, also known as swine flu, is especially of high risk for development of complications in pregnant women. The influenza A virus infection is difficult to diagnose clinically because its presenting symptoms are similar to those of the common cold but are more severe, last longer, and can be potentially life-threatening. This case also presented with common cold symptoms but her condition worsened later. Fortunately, obstetric health providers were vigilant enough to address the developing infection and its related complications. It was the cooperative effort of multidisciplinary team care which resulted in a favourable outcome in both mother and baby.
Antiviral Therapy, 2011
was significantly more severe in pregnant than in nonpregnant women. In Spain, antiviral therapy was recommended for pregnant women from the beginning of the 2009 pandemic. Methods: The prospective cohort study included consecutive pregnant and non-pregnant women of reproductive age with a proven diagnosis of 2009 A(H1N1)v admitted to any of the 13 participating Spanish hospitals between 12 June and 10 November 2009. Results: In total, 98 pregnant and 112 non-pregnant women with proven 2009 A(H1N1)v hospitalized during the study period were included. Influenza was more severe among non-pregnant patients than pregnant patients with respect to outcomes of both intensive care unit admission (18% versus 2%; P<0.001) and death (5 versus 0; P=0.06). Pregnant women had fewer associated comorbid conditions other than pregnancy (18% versus 44%; P<0.001); they were also admitted earlier than non-pregnant women (median days since onset of symptoms: 2 versus 3; P<0.001) and a higher percentage received early antiviral therapy (41% versus 28%; P=0.03). Neither a multivariate nor a matched cohort analysis found pregnancy to be associated with greater severity than that associated with hospitalized, seriously ill non-pregnant women. Conclusions: 2009 A(H1N1)v influenza was not associated with worse outcomes in hospitalized pregnant women compared with non-pregnant ones of reproductive age in a context of early diagnosis and antiviral therapy.
Severe 2009 A/H1N1v influenza in pregnant women in Spain*
Critical Care Medicine, 2011
Objectives: To describe the severity of the 2009 influenza H1N1v illness among pregnant women admitted to Spanish intensive care units. Design and Patients: Prospective, observational, multicenter study conducted in 148 Spanish intensive care units. We reviewed demographic and clinical data from the Spanish Society of Intensive Care Medicine database reported from April 23, 2009, to February 15, 2010. We included women of reproductive age (15-44 yrs) with confirmed H1N1v infection admitted to intensive care units.
Critical illness with AH1N1v influenza in pregnancy: a comparison of two population‐based cohorts
BJOG: An International Journal of Obstetrics & Gynaecology, 2010
Please cite this paper as: Knight M, Pierce M, Seppelt I, Kurinczuk J, Spark P, Brocklehurst P, McLintock C, Sullivan E, on behalf of the UK’s Obstetric Surveillance System, the ANZIC Influenza Investigators, and the Australasian Maternity Outcomes Surveillance System. Critical illness with AH1N1v influenza in pregnancy: a comparison of two population‐based cohorts. BJOG 2011;118:232–239.Objective To compare admissions to intensive care units (ICUs) with confirmed AH1N1v influenza in pregnancy in Australia, New Zealand and the UK.Design National cohort studies.Setting ICUs in Australia, New Zealand and the UK.Population Fifty‐nine women admitted to ICUs in Australia and New Zealand in June–August 2009, and 57 women admitted to ICUs in the UK in September 2009–January 2010.Methods Comparison of cohort data.Main outcome measures Incidence of ICU admission, comparison of characteristics and outcomes.Results There was a significantly higher ICU admission risk in Australia and New...
Postpandemic Influenza A/H1N1pdm09 is still Causing Severe Perinatal Complications
Mediterranean journal of hematology and infectious diseases, 2015
Although influenza A/H1N1pdm09 is not causing a pandemic anymore, we recently observed two critically ill pregnant women infected by this virus. We present these cases to illustrate the possible severe complications of an - at that moment - seasonal influenza in pregnancy. We discuss the epidemiological differences between the pandemic and post pandemic phase and try to explain the high virulence of influenza A/H1N1pdm09 -infections in pregnancy by discussing insights in immunology during pregnancy. We conclude that although influenza A/H1N1pdm09 is in the post pandemic phase, infection by this influenza virus still needs to be considered in pregnant women with progressive respiratory dysfunction.