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Whether it is seasonal flu or swine flu, all pregnant women should have a clear plan on what do in case she has influenza like symptoms. |
Why H1N1 virus is sometimes called “swine flu”?
The H1N1 virus was originally referred to as “swine flu” because laboratory testing showed that many of the genes in this new virus were very similar to influenza viruses that normally occur in pigs (swine). It has two genes from flu viruses that normally circulate in pigs in Europe and Asia and bird (avian) genes and human genes. Scientists call this a "quadruple reassortant" virus.
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What if I get H1N1 influenza while I am pregnant?
This new influenza virus is like the viruses that cause regular seasonal influenza and affects the respiratory system (nose, throat and lungs). Pregnant women are not at greater risk to become ill with H1N1 compared to the rest of the population. However, if they are infected with influenza, pregnant women are more likely to develop complications during the pregnancy or in the first 4 weeks following birth.
Examples of complications include pneumonia (lung infection) and the early onset of labour. However, in the majority of cases, pregnant women who catch the H1N1 flu have only a mild disease and make a full recovery. This type of virus does not usually cause problems in unborn babies, but we do not yet have all the information, therefore, we have to be careful.
Every pregnant woman should have a clear plan on how to protect herself and what to do in case she develops influenza like symptoms.
Should pregnant women take the flu vaccine?
The H1N1 and seasonal flu vaccines are highly recommended for all pregnant women. Being a new vaccine, we advise you to read about H1N1 vaccine and decide with your doctor if you want to take it. The vaccine should be provided by your doctor or the health care centre where you normally visit.
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What should I do if I have flu like symptoms?
It is vital that during any illness pregnant women maintain their fluid levels to prevent dehydration which may affect the fetus due to low amniotic fluid levels. Additionally, common cold and or pain medications should never be taken without approval from the attending physician.
This is especially important during the first trimester:
- Stay home, limit contact with others.
- Treat any fever above 380 C with Paracetamol.
- Drink plenty of fluids to replace those you lose due to high temperature.
- If you are alone and ill at any time, have someone check in with you often.
- Contact your doctor/health care centre if you have any concerns
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What are antiviral drugs?
An antiviral drug is a medication that stops the germs from growing in your body. It is usually taken for 5 days. Tamiflu is one of the few antiviral drugs.
Can I take antiviral medication (Tamiflu) during pregnancy?
Antiviral drugs are NOT recommended if you have ONLY been in contact with someone who has the flu. However, if you do catch the flu during pregnancy or within 4 weeks from giving birth, your doctor might start you on an antiviral drug if you develop the following:
- High fever (>380C) AND new or worse cough or shortness of breath, plus one or more of the following symptoms:
- Sore throat
- Painful muscles or joints
- Extreme fatigability
Is Tamiflu safe to take during the first trimester of pregnancy?
Although there is very little information about the safety of Tamiflu in human pregnancy, animal studies do not suggest there is a risk to the fetus. Tamiflu can be used in pregnancy to avoid serious complications. Influenza during pregnancy can lead to pneumonia, and infection might pose a risk to your unborn baby. In addition, pyrexia (high fever), particularly in the first trimester is associated with an increased risk of congenital fetal abnormalities such as neural tube defect and miscarriage.
Do I still need to seek medical advice even if I was started on antiviral medication?
Even if you were started on Tamiflu, you still need to seek medical advice if you have any of the following:
- Difficulty breathing, shortness of breath or chest pain.
- Bloody sputum (phlegm).
- A high fever not responding to Paracetamol
Confusion.
- Sudden dizziness.
- Severe or persistent vomiting.
If you have SEVERE flu-like symptoms you MUST SEEK MEDICAL ATTENTION
If your primary concern is severe flu symptoms, go to the Emergency Department |
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What if I have flu like symptoms at the time of my elective caesarean section or induction of labour?
If there is a pressing obstetric reason to proceed with induction or caesarean section, then your obstetrician should proceed as planned. However, if it is reasonable from the obstetric point of view to delay delivery for five days, then the procedure should be postponed. This will give you time to recover from your acute illness and will help reduce the risk to staff and other women in the hospital from contracting the virus.
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If I get H1N1 flu, for how long I will remain infectious?
For pregnant and non-pregnant women, H1N1 has an incubation period of up to 4 days. People who tested positive for H1N1 are infectious for 24 hours before and up to 7 days after onset of symptoms. You might remain infectious up to10 days if you were very ill.
Is it OK to breastfeed my new baby if I am sick?
Breastfeeding is recommended because breast milk contains antibodies that protect babies from infection. Babies who are breastfed get sick less often compared with babies who are bottle-fed.
Do not stop breastfeeding if you are ill.
Breastfeed early and often.
Limit formula feeds if you can.
Wash your hands before feeding or handling your baby
Be careful not to cough or sneeze in the baby’s face.
Consider wearing a mask to keep from spreading this new virus to your baby.
It is better to pump and have someone give the expressed milk to your baby.
Contact your baby’s doctor if you think your baby:
- Has signs of the flu.
- Is not feeding well.
- Is unwell.
Is it OK to take medicine to treat or prevent H1N1 flu while breastfeeding?
Yes, mothers who are breastfeeding can continue to nurse their babies while receiving antiviral treatment for H1N1 flu. Recently published studies on antiviral medications in breastfeeding women have shown that the concentration of the drug that crosses into the breast milk is minimal and is considered to be a safe amount for an infant to ingest.
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References:
http://www.rcog.org.uk/news/swine-flu-alerts
http://www.hc-sc.gc.ca
http://www.cdc.gov/h1n1flu/guidance/4
http://www.cdc.gov/H1N1flu/pregnancy/antiviral_messages.htm
2009 H1N1 Flu (Swine Flu) and Feeding your Baby: What Parents Should Know
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