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25-05-2010 | Infectious disease | Article

Swine flu may cause obstetric complications in pregnant women


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MedWire News: Results from a US study show that pregnant women with H1N1 influenza (swine flu) are at increased risk for obstetric complications.

“Little data have been reported regarding the impact of H1N1 on pregnant patients or the gestational fetus, and published reports have been conflicting,” explain Andrew Miller (State University of New York) and team.

“Because obstetrical patients make up a vulnerable population, it is crucial to characterize in them the severity and course of H1N1.”

The researchers therefore studied data on 18 pregnant women, aged 18–40 years, with H1N1 influenza who were admitted to one of two urban medical centers between May and June 2009.

H1N1 influenza was confirmed using direct antigen testing (DAT) of nasopharyngeal swabs followed by real-time reverse-transcriptase polymerase chain reaction analysis or viral culture. All of the patients were treated with oseltamivir phosphate from the first day of admission.

The researchers found that the women’s median length of stay in hospital was 4 days, and three were admitted to the intensive care unit. Half of the patients reported suffering from gastrointestinal or abdominal complaints, and 13 met criteria for sepsis.

Overall, seven patients delivered during their hospital stay. Of these, six women delivered prematurely (gestational age <37 weeks), four deliveries required emergency cesarean delivery, and five involved fetal distress.

In total, two fetal deaths occurred, both of which resulted from spontaneous abortion at a gestational age of less than 23 weeks.

No maternal deaths were recorded and no congenital birth defects were identified.

Miller and team conclude in the Archives of Internal Medicine: “Admitted pregnant patients with H1N1 are at risk for obstetrical complications including fetal distress, premature delivery, emergency cesarean delivery, and fetal death.”

They add: “The absence of maternal mortality in the present series (versus its presence in prior studies) may be related to early antiviral treatment.”

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Mark Cowen


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