MATERNAL AND FETAL OUTCOMES OF PREGNANCIES TREATED FOR H1N1 VIRUS INFECTION

B. C. Demir, Ayşe Topçu Akduman, Nefise Tanrıdan Okçu, Y. Kímya, Kamil Turgay, B. Durak, Hüseyin Tan, Emel Özalp, G. Bademci, S. Artan
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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.
接受h1n1病毒感染治疗的孕妇和胎儿结局
目的:在甲型H1N1流感(通常被称为猪流感)爆发时,土耳其于2009年5月确诊了第一例病例。世界卫生组织(世卫组织)宣布2009年6月至2010年8月为H1N1大流行时期。在本研究中,我们旨在评估2009年流感大流行期间住院的诊断为h1n1病毒感染的孕妇的母胎结局。材料与方法:回顾性分析9例H1N1感染孕妇的临床资料、治疗方式及母婴结局。实时荧光定量PCR (rRT-PCR)检测结果为确诊病例,rRTPCR检测结果为阴性为疑似病例。结果:入院时1例为妊娠早期,2例为妊娠中期,6例为妊娠晚期。主要症状为咳嗽(77%)、发烧(77%)、喉咙痛(11%)、呼吸困难/呼吸窘迫(44%)和不适(22%)。所有患者均给予奥司他韦治疗,继发性细菌性肺炎患者给予适当的抗生素治疗。中位住院时间为23天(7-40天)。5例患者需要机械通气支持。1名患者和2名新生儿死亡。结论:虽然猪流感在大多数人群中引起轻度至中度流感样症状,但在孕妇中可能导致致命的并发症。因此,适当的抗病毒治疗应在48小时内立即开始。
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