Severe Influenza A Virus (H1N1) Infection in Pregnancy

BACKGROUND: H1N1 influenza is an emerging threat that is life threatening to pregnant women in the third trimester. Six third-trimester maternal deaths with severe H1N1 pneumonia and acute respiratory distress syndrome (ARDS) have been reported in the literature. CASE: A young woman at 33 weeks of gestation was admitted for bilateral pneumonia with increasing hypoxia. Shortly after admission, she decompensated, requiring transfer to the intensive care unit. After testing confirmed H1N1, her respiratory status declined rapidly, necessitating intubation, mechanical ventilation, and emergent bedside preterm cesarean delivery. After delivery, she developed ARDS, requiring prolonged mechanical ventilation, yet she survived and has recovered. CONCLUSION: H1N1 influenza is especially dangerous to pregnant women. (Obstet Gynecol 2010,115:412-4)