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Pregnant women infected with the H1N1 virus are at such high risk of complications that they should be treated at once with the antiviral drug Tamiflu. Although the usage of medicines are not normally recommended in pregnancy, the deadly virus can cause pneumonia, dehydration and premature labor, the Centers for Disease Control and Prevention said.

As positive tests for the flu can take several days, Tamiflu should be given to any pregnant patient with flu symptoms and any history of exposure to the flu. The New York Times reported:

“If I’m thinking influenza— the classic symptoms, febrile, aching all over, came on all of a sudden — and this flu is in the community, and I’d otherwise give the patient Tamiflu if she wasn’t pregnant, we’re saying, ‘Don’t delay because she’s pregnant,’ ” said Dr. Denise Jamieson, a C.D.C. medical officer. “At that point, the benefit of giving Tamiflu outweighs the risk.”

The effects of the drug on the unborn child is unknown, said Tamiflu maker, Roche. Dr. Jamieson added "because you don't do clinical trials in pregnant women." However, she said that the antiviral drug is fairly safe in pregnancy.

One of the three deaths in the United States involved a pregnant woman who wasn't under any medication besides prenatal vitamins. The woman, Judy Trunnel, 33, was relatively healthy at that time despite mild asthma and psoriasis. She recieved Tamiflu a few days after being tested positive for the flu.

Mrs. Trunnell was eight months pregnant when she entered the hospital with pneumonia on April 19, five days after flu symptoms began and she had been found flu-positive in a doctor’s office test. Her baby was delivered by Caesarean section and is healthy. She developed acute respiratory distress on April 21 and needed mechanical ventilation. She did not get Tamiflu until April 28. She died May 4.

The U.S. now has over 3,000 confirmed cases of the flu, but only 116 hospitalizations.

Drugs Urged for Swine Flu in Pregnancy [The New York Times]
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