Clinical and evolution particularities of pandemic influenza A(H1N1) in pregnant women

Abstract

Introduction: Influenza A (H1N1) it is acute infectious disease caused by a new type of virus emerged after the combination of three viruses: human, swine and avian global pandemic. Changes in the immune, cardiac and respiratory systems are likely reasons that pregnant women are at increased risk for severe illness with influenza. During previous pandemics, mortality rates among pregnant women appeared elevated, and data from seasonal influenza demonstrate that pregnant women are at higher risk for the life of the pregnant woman and fetus. H1N1 infection in pregnancy with increase in mortality rate (25% versus 8% in nonpregnant women). Purpose and objectives: Evaluation of the clinical, epidemiological and evolutionary particularities of influenza A (H1N1) in pregnant women in different trimesters of pregnancy. Materials and methods: I realized a retrospective study on the 42 pregnant women hospitalized in the IMSP Municipal Maternity Nr.2, Chișinău, during 2009-2011. The average age of pregnant women with influenza A (H1N1) included in the study was about 23±4,1 year, the average of gestation period 20,7±6,2 weeks. Pregnant women were investigated clinicaly and laboratory(PCR). Results: Influenza A (H1N1) has similar clinical symptoms to seasonal flu with the symptoms: asthenia(95,2%), fever( 90,4%), headache(83,3%), myalgia (21.4%), arthralgia(l 1,9%), dry cough (78.5%), moist cough (21.4%), retrosternal pain( 7.1%), rinorea-(76,2%). Dyspnea symptom- in 3 cases 7,1%. Complications in pandemic influenza in pregnancy: early miscarriage 5(11,9%), late miscarriage 2 (4,7%), imminence of premature labor 8(19.1%). Pulmonary complications: laryngotracheitis 4 (9.5%), bronchitis, 13 (30.9%), bronchopneumonia - 5 (11.9%), pneumonia, two (4.8%) pregnant women and others complications: exacerbation of chronic pyelonephritis - 7 pregnant women (16,7%). Conclusions: Respiratory pathology involves a two fold risk for mother and child lives. Results of studies demonstrated the impact of the virus A (H1N1) on pregnancy outcome having miscarriage effect in early/ late terms of pregnancy and imminence of premature labor in the 2 and 3 trimester.