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    Swine Flu and Pregnancy

    Could these medications cause harm to her unborn baby?

    Some adverse effects have been reported in pregnant animals given Tamiflu, but no relation between the use of the drug and adverse events in pregnant women has been established.

    “The risk of complications from untreated influenza greatly outweighs any of the theoretical risks related to taking either Tamiflu or Relenza,” says Mark Phillippe, MD, MHCM, professor and chairman of the department of obstetrics, gynecology, and reproductive sciences at the University of Vermont College of Medicine.

    Can a pregnant woman pass swine flu to her unborn baby?

    “During severe infections with pandemic strains of influenza, it’s possible that the virus could infect the placenta, which carries blood to the fetus,” says Phillippe. While its to soon to know much about how swine flu affects a fetus, women with swine flu do seem to be at a higher risk for premature delivery. In past pandemics, pregnant women with flu had higher rates of stillbirth, spontaneous abortion, and premature birth.

    Also, flu comes with fever. Studies have shown that a fever during the first trimester doubles the risk of neural tube defects and may be associated with other adverse outcomes. The risk for birth defects associated with fever may be mitigated by the use of anti-fever medications and/or a multivitamin that contains folic acid, but data are limited.

    What happens if a woman comes down with swine flu right before her baby is born, or when the baby is a newborn?

    She should deliver the baby at a hospital that is prepared for this type of delivery. A surgical mask should be placed on the ill mother during labor and delivery, and she should consider avoiding close contact with her infant until she has received antiviral medications for 48 hours and her fever has fully resolved. This will reduce, but not eliminate, the risk of transmitting H1N1 to the infant.

    Infants are thought to be at higher risk for severe illness if they get swine flu, and very little is known about prevention in infants. If possible, only adults who are well should care for infants, including feedings.

    If she gets sick after the delivery, her newborn should be cared for by someone who is well, until she feels better and for at least seven days after the onset of her symptoms. She may begin breastfeeding (or if not able to breastfeed, bottle feeding), and should wear a face mask.

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