The latest data has shown that pregnant women are at greater risk for complications from swine flu than the general public. Pregnant women were more likely to need hospitalization if infected. During the initial phase of the swine outbreak, there were 34 confirmed cases in pregnant women of which 32% required hospitalization. There were 6 deaths from swine flu in pregnant women by June, from pneumonia and respiratory distress requiring a ventilator. It is therefore imperative that treatment with antiviral drugs be initiated swiftly if H1N1 flu is suspected. Doctors treating pregnant women for flu symptoms should have a very low threshold for starting antiviral therapy.
The two antiviral medications, oseltamivir and zanamivir are relatively safe in pregnancy and breast feeding women. Of the two medications, oseltamivir (Tamiflu) appears to be the first drug of choice since there is more data on safety.
The limited supply of the H1N1 vaccine should be available in the fall and pregnant women will be considered one of the high risk groups taking priority for vaccination since they are more likely to have an adverse outcome if they contract the disease. Vaccine will protect both mom and newborns up until about 6 months of age. Controlling fever with Tylenol in the first trimester is also especially important in pregnancy to prevent neural tube defects in the newborn.
