Maternal and fetal outcomes of pregnancies treated for H1N1 virus infection

Abstract

Aim: At the time of the outbreak of influenza A H1N1, mostly known as swine flu, first case in Turkey was diagnosed in May 2009. The period from June 2009 to August 2010 was declared to be pandemy H1N1 by World Health Organization (WHO). In this study we aimed to assess the maternal and fetal outcomes of pregnant women with the diagnosis of H1N1viral infection, who were hospitalized during 2009 pandemy.Materials and methods: The clinical data, treatment modalities and maternal and fetal outcomes of 9 pregnant women with H1N1 infection were retrieved from patients file and evaluated retrospectively. Patients were classified as confirmed case if the nasopharyngeal swabs were pozitive with real time PCR (rRT-PCR) and suspected case if rRTPCR was negative.Findings: At admission one patient was in first trimester, 2 were in second trimester and other 6 patients were in third trimester. The presenting symptoms were cough (77%), fever (77%), sore throat (11%), dyspnea/ respiratory distress (44%) and malaise (22%). All of the patients were treated with oseltamivir and with appropriate antibiotics in case of secondary bacterial pneumonia. Median hospitalisation time was 23 days (7- 40). Five patients required mechanical ventilatory support. One of the patients and 2 of the neonates passed away.Conclusion: Although swine flu causes mild to moderate flu like symptoms in most of the population, in pregnant women it may lead to lethal complications. Thus the appropriate antiviral treatment should begin immediately within 48 hours.