H1N1 and pregnancy

WHEN I read recently that a pregnant woman and her unborn baby had died of complications due to H1N1 infection, I was terribly saddened that not one, but two lives, were robbed from this earth.

It’s easy to see why women, particularly pregnant mothers, are worried about H1N1 – both for themselves and their unborn babies.

This is not any ordinary flu virus, but a novel (meaning new) strain that has never infected humans before. It is highly contagious and most people have not developed natural immunity against it yet.

Is it harmful during pregnancy?

Many of my patients have already asked me about the potential dangers of H1N1. Many are worried that if they become infected, there will be serious consequences.

There is cause for concern, because pregnancy is considered one of the risk factors that make a person more vulnerable to infection and developing complications.

If you’re pregnant, your immunity to infection is slightly lowered – this is Nature’s way of stopping you from rejecting your unborn baby. This increases your risk to infections, even to normal flu.

A pregnant woman’s immune system also shifts away from the kinds of immune responses most effective in battling viral infections. This makes her more susceptible to some viral diseases such as flu.

Pregnancy also increases the risk of developing complications of the flu, such as pneumonia and respiratory distress. This is because pregnancy puts extra stress on the heart and lungs, pushing a woman’s diaphragm upward and decreasing her lung capacity. This makes any type of respiratory disease more dangerous.

In turn, flu complications may lead to miscarriage, premature labour or other pregnancy problems.

But don’t panic – remember that I have only mentioned “risk”. That does not mean certainty, and it definitely means that you can protect yourself.

If you are healthy and fit, your immune system will still function well and you will probably only have mild symptoms of H1N1.

What to do if you are infected

The truth is, H1N1 is so contagious that most people who come down with flu today probably have this strain of virus. So everyone, including pregnant women, must be prepared to manage this and learn to recognise the signs of danger.

Be wary if you have flu-like symptoms, such as cough, sore throat, runny nose, and muscle pain together with a fever above 38ºC.

You should also monitor for more severe signs like acute abdominal pain, continuous diarrhoea, vomiting, coughing up blood or fever above 38ºC for more than two days.

Antivirals and pregnant women

If the serious symptoms above occur, you should go to the nearest clinic or hospital immediately and tell them that you are pregnant.

You will most likely be prescribed antiviral drugs. These drugs do not cure H1N1 but will relieve the symptoms and reduce the likelihood of complications developing.

Many pregnant women are worried about the possible side-effects of antiviral drugs on their unborn baby. There is no evidence that antivirals will cause adverse effects in pregnancy – and remember that untreated H1N1 infection will be more dangerous to you and your baby than the effects of the medication.

H1N1 and breastfeeding

If you are currently breastfeeding your baby, you should continue to do so even if you are infected or suspected to be infected with H1N1. This is because breastmilk contains antibodies that help your baby fight off infections, including influenza viruses.

So do not stop breastfeeding if you are ill with influenza-like symptoms. You can also breastfeed if you are being treated for the flu with normal flu medication or antivirals. Breastfeed early and often, and limit formula milk.

Be careful not to sneeze or cough into your baby’s face, and wear a mask when you are nursing or near your baby. Wash your hands regularly with soap and water, especially before and after nursing.

If you are too sick to breastfeed, try to express your milk and have someone give the milk to your baby so that you will continue producing milk after you have recovered.

Preventing H1N1 infection

The best strategy, of course, is to minimise the chances of infection. Personal hygiene is the best answer here.

Wash your hands frequently with soap and water, or with a hand sanitiser, especially after touching surfaces in public places like doorknobs, telephones, and banisters.

Avoid contact with people who have flu-like symptoms, or try to stay at least one metre apart from them. Wearing a mask can also help reduce your chances of infection, but be sure not to wear a mask that will cause breathing difficulties.

Don’t touch your eyes, nose, or mouth with your hands because that’s how the germs will enter your body.

Avoid going to crowded places or unnecessary travel if you are pregnant, because it is better to be safe.

Do your part to minimise infection to others as well by covering your nose and mouth with a tissue when you cough and sneeze. Wash your hands with water and soap after coughing or sneezing.

Finally, if you have flu-like symptoms, drink plenty of fluids, stay at home, and get bed rest in a ventilated room, and eat a healthy diet with plenty of fruits, vegetables, and wholegrain foods.

H1N1 is among us all today, and we should all play our part in ensuring that we protect each other from becoming infected, especially those who are more vulnerable, such as children, pregnant women, the elderly, and people with chronic medical conditions.

Datuk Dr Nor Ashikin Mokhtar is a consultant obstetrician & gynaecologist (FRCOG, UK). For further information, visit www.primanora.com. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.