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Swine flu and pregnancy

The danger of contracting swine flu during pregnancy has been noted by Margaret Chan, director of the World Health Organisation "Without question pregnant women are at increased risk of complications. This heightened risk takes on added importance for a virus, like this one, that preferentially infects younger age groups," she said.

The immune system is naturally suppressed in pregnancy because the foetus is a foreign body that might otherwise be rejected. This makes pregnant women more susceptible to all infections, including seasonal and swine flu.

Possible complications are pneumonia (an infection of the lungs), difficulty breathing and dehydration, which are more likely to happen in the second and third trimester.

There is a small chance that these complications will lead to premature labour or miscarriage. There is not yet enough information to know precisely how likely these birth risks are.

It is important to note that most pregnant women are expected to have only mild symptoms and recover within a week.

If you think that you may have swine flu, check your symptoms online. If you are still concerned, call your doctor for an assessment immediately. If your doctor confirms swine flu over the phone, you are likely to be prescribed antiviral medication such as Tamiflu and Relenza to take as soon as possible. The side effects of these anti-virals for pregnant women are not yet totally clear, so it is important to keep yourself informed as more knowledge becomes available.

You can take paracetamol-base cold remedies to reduce fever and other symptoms. However, pregnant women should not take non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Nurofen).

Dr. Danuta Skowronski, a flu expert with the British Columbia Centre for Disease Control, has published a review article on influenza immunization in early pregnancy in the journal Vaccine. In looking at the evidence about the impact of influenza on pregnancy, she and co-author Dr. Gaston De Serres of Laval University noted that the fatality rate was higher in pregnant women during the 1918 and 1957 pandemics, though not the milder pandemic of 1968.

Skowronski said that given the fact that younger adults don't appear to have antibodies to the new swine flu virus, similar results may be on the cards during a swine flu pandemic.

"If we base it on what we know of the 1918, 1957 pandemics, what we know about pre-existing antibody levels to swine influenza in the population, based on that I would say for this particular virus, pregnant women may suffer more serious consequences, especially in the third trimester," she said.

"And they should probably seek care early if they have influenza-like illness."

Studies done after the disastrous 1918 Spanish flu - which took its heaviest toll on young adults - showed astonishing death rates among pregnant women, said Dr. Michael Osterholm, an infectious diseases expert at the University of Minnesota.

Skowronski's review paper suggests there were also very high rates of spontaneous abortions during that pandemic - 26 per cent in pregnant women who became infected and 52 per cent among those who went on to develop pneumonia from their infection.

If you are pregnant, you can reduce your risk of infection by avoiding unnecessary travel and avoiding crowds where possible. Pregnant women should also follow the general hygiene advice.

General advice is that it's important not to panic - for most women who are pregnant or trying to conceive, the stress and anxiety of worrying about getting sick is more likely to cause them harm then the threat of the virus itself!

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