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Pregnant women are at higher risk from the new H1N1 flu. Several countries, including the United States, have reported an increased risk of severe or fatal illness in pregnant women, especially during their second and third trimesters of pregnancy.
Pregnant women are more likely to get sick than others and have more serious problems with seasonal flu. Those problems include early labor and severe pneumonia. Health officials do not yet know if the H1N1 flu will cause the same problems, but pregnant women should take every precaution to reduce their risk of getting the flu and seek early treatment if they become sick.
When to call the doctor
Pregnant women who have flu-like symptoms should call a health care provider immediately. The doctor will determine whether treatment is needed.
- H1N1 flu symptoms are similar to those of the seasonal flu: fever, cough, sore throat, body aches, headache, chills and fatigue and, on sometimes, diarrhea and vomiting.
- Antiviral medications are effective for treating the H1N1 flu. Two medications, Zanamivir and Oseltamivir (commercial names Relenza® and Tamiflu®), are available, but the preferred drug for treating pregnant women with the H1N1 flu is Oseltamivar.
Antiviral treatment should begin as soon as possible, preferably within 48 hours after symptoms begin. The medication should be taken for five days. Some studies show that receiving treatment more than 48 hours after symptoms begin can also be beneficial.
Note: There is little information about the effect of antiviral drugs on pregnant women or their babies, but no serious side effects have been reported. If side effects do occur, a health care provider should be contacted immediately.
- Fever during pregnancy is associated with an increased risk of birth defects and other health problems. Acetaminophen (Tylenol®) appears to be the best medication for bringing down fever in pregnant women.
- Pregnant women who have had close contact with someone who has H1N1 flu – or who has symptoms and suspects H1N1 flu – should immediately call their health care provider. Their doctor will decide whether to prescribe antiviral medication. If preventive medication is prescribed, it would be taken for 10 days.
When to seek emergency medical care
A pregnant woman should seek emergency medical treatment if she experiences any of the following symptoms:
- Difficulty in breathing
- Pain or pressure in the chest or abdomen
- Sudden dizziness
- Confusion
- Severe or persistent vomiting
- Decreased or no movement of the baby
- A high fever that is not reduced by acetaminophen (Tylenol)
Reducing the risk of H1N1 flu
To reduce the spread of the flu, pregnant women should take the same precautions as the general public:
- Wash your hands frequently with soap and water, especially after coughing or sneezing. If soap is not available, alcohol-based hand cleaning gels are also effective.
- Cover your coughs and sneezes with a tissue and then throw the tissue away. If tissue is not available, cough into the inside of your elbow.
- Avoid touching your eyes, nose or mouth. The virus can remain on frequently touched objects such as doorknobs after an infected person touches them.
- Stay home if you have flu-like symptoms, especially if you have a fever, except to seek medical care. Before visiting a doctor’s office, call ahead and tell them that you are ill and that you are coming to their office.
- Avoid or minimize contact with others who might be sick.
- Avoid crowds, if possible, whenever there is a flu outbreak.
Information for women who are breastfeeding
A woman taking antiviral medications to treat the flu can continue to breastfeed her baby. A mother’s milk helps her baby ward off disease. This is especially important in newborns whose immune systems are still developing.
- A mother should not stop breastfeeding her child if she becomes ill. However, she should take steps to reduce the risk of spreading the illness to her baby. She should be careful not to cough or sneeze in the baby’s face and she should wash her hands often with soap and water. Her doctor may ask her to wear a mask to help keep from spreading germs to her child.
- If a woman is too sick to breastfeed, she should pump her milk and have someone else feed it to her baby. The risk for transmitting swine flu through breast milk to a baby is unknown. However, reports of passing seasonal flu through breast milk have been rare.
More information about the flu’s effect on pregnant woman can be found on the CDC’s Web site at: www.cdc.gov/h1n1flu/guidance/pregnant.htm
Clinicians can obtain more information at: http://www.cdc.gov/h1n1flu/clinician_pregnant.htm. |
