Evidence of swine flu risk to pregnant women rises; experts urge early treatment
Remember that the CDC is now recommending special considerations for pregnant HCW. Most hospitals and health care facilities have not yet implemented those guidelines. They might not if no one mentions this to Risk Management. Feel free to copy this article and show it to RM with the CDC guidelines. I am going to be doing this also.
If you are pregnant and you get sick, take the Tamiflu. It is safer than not taking it.
First a link to the gudelines, then the article:
Quote from www.google.com
There are mounting and troubling signs that swine flu and pregnancy don't mix well.
Six pregnant women in Manitoba are reportedly on ventilators because they are severely ill with the virus.
And at least two pregnant women in the United States have died of swine flu complications after delivering babies by C-section.
A pregnant teenager in the Dominican Republic died, as did a pregnant woman in Scotland.
A woman in St. Theresa Point, a First Nations community in Manitoba, miscarried after contracting swine flu.
Humankind's relationship with the new swine H1N1 virus is still in its infancy. But people who've studied the issue of pregnancy during flu pandemics don't like the signs they are seeing. Dr. Denise Jamieson, an obstetrician-gynecologist with the U.S. Centers for Disease Control's division of reproductive health, says she finds the evidence to date "very unsettling."
"I am concerned about this," Jamieson said in an interview from Atlanta.
"There does seem to be increased severity in pregnancy. We don't have hard and fast numbers but there are enough reports that are concerning."
Data released by the CDC last month said at that point, 17 per cent of Americans hospitalized for severe swine flu infections were pregnant women.
A report a couple of weeks back in the World Health Organization's journal, Weekly Epidemiologic Record, noted of 30 swine flu patients hospitalized in California, five were pregnant women. Of those, two developed severe complications - spontaneous abortion and premature rupture of membranes.
...the fatality rate was higher in pregnant women during the 1918 and 1957 pandemics, though not the milder pandemic of 1968.
"If we base it on what we know of the 1918, 1957 pandemics, what we know about pre-existing antibody levels to swine influenza in the population, based on that I would say for this particular virus, pregnant women may suffer more serious consequences, especially in the third trimester," she said.
"And they should probably seek care early if they have influenza-like illness."
Studies done after the disastrous 1918 Spanish flu - which took its heaviest toll on young adults - showed astonishing death rates among pregnant women, said Dr. Michael Osterholm, an infectious diseases expert at the University of Minnesota.
Skowronski's review paper suggests there were also very high rates of spontaneous abortions during that pandemic - 26 per cent in pregnant women who became infected and 52 per cent among those who went on to develop pneumonia from their infection.
Osterholm explained pregnancy is a precarious state for a woman from an immunological point of view. In order that the mother's body does not reject the fetus, part of the immune system has to be effectively dialled down.
Other factors are also believed to come into play, including reduced lung capacity, Jamieson added.
She said that while the CDC doesn't yet have firm numbers, they are hearing that some pregnant women are reluctant to take antiviral drugs when they are diagnosed with swine flu. In some cases, their physicians share the reluctance.
Jamieson said given the risk swine flu poses to pregnant women, any who feel they may have contracted it should seek care quickly and should tell their doctor about potential exposures to people who had the virus. And they should take the antiviral drugs, she said.
"The message we're trying to get out is: 'Don't delay. If you suspect influenza, initiate antiviral therapy appropriately even before you get the testing back," Jamieson said.
"We definitely feel like in a situation like this, the benefits outweigh the risks of giving antiviral medication."
Jun 25, '09
I am going to list all of the pregnant cases that I know of as having been affected by swine H1N1. These are in addition to the Scottish woman mentioned in the last link and the 6 women on vents in Manitoba, already mentioned in this thread. I want to keep track of these cases in one spot.
Judy Trunnell of Allen, Texas, had an emergency C-section and died.
There were five pregnant women in this report, and two miscarried.
Jessica Avalo of El Paso, Texas had an emergency C-section and died.
Caitlin Huber of Chicago, Illinois, died in childbirth.
Last edit by indigo girl on Jun 25, '09
Jun 25, '09
Buenos Aires, Argentina
There were two young pregnant women that died in Buenos Aires.
Quote from www.buenosairesherald.com
A pregnant woman died after contracting the virus in Buenos Aires province.
The 24-year-old woman had been hospitalized at the Güemes clinic in the district of Luján, after she showed symptoms of the illness.
Sources said the mayor of Luján, Graciela Rosso and the local Health Secretary, Héctor Ruffinelli, will give a press conference this afternoon to comment on the details of the case.
Media in Buenos Aires reported that another pregnant woman died. The 19-year-old woman had been hospitalized in Larcade Hospital in San Martin district and died on Tuesday morning, Malbrán Institute is analyzing her test to confirm if she died of H1N1 virus.
Here is a translation of an article about these two cases.
Quote from www.flutrackers.com
...a young pregnant 24-year-old native of General Rodriguez, who died in the clinic Güemes victim of influenza. Despite the situation, the doctors managed to save the baby, who at this time remains stable.
asures to take to the increase in deaths.
On the other hand, hopes the results of swabs done to another pregnant girl, 19, who died on Wednesday at the Hospital Doctor Lacarde, San Miguel (Buenos Aires province), because of pneumonia complications at a table that could be compatible with influenza A H1N1. From the Secretary of Health of the local council said the newspaper Crítica that the results of samples sent to the Institute Malbrán be ready at noon today.
Last edit by indigo girl on Jun 25, '09
Jun 30, '09
Five Pregnant Women in ICU in Bay Area
If this is what is happening in late June, what can we expect this fall?
Dr. Mulvihill did not get her facts staight about the Tamiflu resistant case in Denmark. The case was female.
(hat tip PFI/heddie)
Quote from cbs5.com
...at least five pregnant women have been hospitalized in Bay Area intensive care units due to complications of the H1N1 swine flu.
Sources said two of the five women are no longer in ICU, but they remained hospitalized. All the fetuses appeared to be fine, the sources indicated.
This may be the first reported cluster of pregnant women infected with H1N1 in the country. One obstetrician who was consulted on all five cases told CBS 5 that he had never seen anything like this before.
All the pregnant women are or were in their early third trimester. Some required intubation or help breathing, sources said.
Some of these women were perfectly healthy, while others had underlying health conditions. While the doctor could not divulge what other health conditions these pregnant women had, the Centers for Disease Control said respiratory conditions such as allergies or asthma or even heart disease, may put a person at a higher risk.
The CDC and the World Health Organization also warned that pregnancy itself may be a risk factor for contracting H1N1.
CDC officials said they don't know why pregnant women may be at a higher risk for contracting swine flu or for complications following a swine flu infection. However, pregnant women, in general, have lowered immune systems.
The doctor interviewed by CBS 5 believes that with infected pregnant women who are in their third trimester, the enlarging fetus in the uterus may be pushing up and against a woman's diaphragm to such a degree, that she can no longer breathe as deeply, and may be at higher risk for pneumonia.
All public health officials and experts agree: if you are pregnant, and experience symptoms, do not panic; do not rush the emergency room or your doctor's office. Instead, call your doctor, describe your symptoms and ask whether you need to be tested.
The symptoms are fever, cough, sore throat, body aches, headaches, chills and fatigue and sometimes diarrhea and vomiting.
The CDC said many pregnant women who are infected with H1N1 will not have a problem. However, for some, the illness might progress quickly and then, may be complicated by secondary bacteria infections, most likely pneumonia.
As for treatment, certain antiviral medications may help. Tamiflu and Relenza are believed safe for use in pregnant and breast feeding women.
Last edit by indigo girl on Jun 30, '09