Outcome of Critical Pregnant and Postpartum Patients of Swine flu- Experience of Seven Years QC12-QC15
Dr. Archana Mishra,
House No. 26-A, Pocket 4, Mayur Vihar Phase-1, East Delhi-110091, India.
Introduction: Pregnancy and postpartum confers four to five fold increased risk for complications and mortality if affected by Swine flu. Swine flu in pregnancy contributes to almost 18-25% of total ICU admissions and high perinatal morbidity and mortality.
Aim: The present study was an analysis of the pattern of critical illness and mortality due to Swine flu virus in pregnant and postpartum women.
Materials and Methods: It was a retrospective study of all clinically suspected, probable as well as confirmed cases of Swine flu, in pregnancy and postpartum period up to two weeks; who were admitted to Swine flu Intensive Care Unit (ICU) from February 2009 to December 2015. We analyzed the presenting complaints, condition on admission, criteria for admission in ICU, abnormalities in laboratory reports, course of illness and perinatal outcome.
Results: In the span of seven years 30 pregnant and 10 postpartum women were admitted in Swine flu ICU. Mortality was 40% (16 out of 40) in pregnant and postpartum women. There were 17 (42.5%) cases which were positive for H1N1 confirmed by Real time-PCR (RT-PCR) and culture. Mean interval of onset of symptoms to start of oseltamivir was four and a half days. Perinatal outcome was poor and only 18% babies were alive after one week of birth.
Conclusion: We emphasize that high index of suspicion, early diagnosis, early antiviral therapy and immunization to pregnant women are the key factors which can reduce the complications, ICU admissions and mortality in this group.