OB-GYN NORTH is the practice of

Christina Sebestyen, MD, FACOG, Tesa Miller, MD, FACOG, April Schiemenz, MD,
Siobhan Kubesh, CNM, Lisa Carlile, CNM, Kathy Harrison-Short, CNM and Katherine Davidson , FPNP

Monday, October 12, 2009

What Should Pregnant Women Know About 2009 H1N1 Flu (Swine Flu)?

These questions and answers have been updated to include new information on 2009 H1N1flu in pregnant women. Both seasonal and 2009 H1N1 flu viruses will circulate during the 2009-2010 flu season. A pregnant woman who thinks she has the flu should call her doctor right away to see if treatment with an antiviral medicine is needed. The medicine is most helpful if it is started soon after the pregnant woman becomes sick. The latest advice for getting seasonal and 2009 H1N1 vaccines during pregnancy is also included.

What if I am pregnant and I get 2009 H1N1?
Call your doctor right away if you have flu symptoms or if you have close contact with someone who has the flu. Pregnant women who get sick with 2009 H1N1 can have serious health problems. They can get sicker than other people who get 2009 H1N1 flu. Some pregnant women sick with 2009 H1N1 have had early labor and severe pneumonia. Some have died. If you are pregnant and have symptoms of the flu, take it very seriously. Call your doctor right away for advice.

What can I do to protect myself, my baby and my family?
Getting a flu shot is the single best way to protect against the flu. Talk with your doctor about getting a seasonal flu shot and the 2009 H1N1 flu shot. You will need both flu shots this year to be fully protected against flu. You should get both shots as soon as they are available to protect you and your baby. The seasonal flu shot has been shown to protect both the mother and her baby (up to 6 months old) from flu-like illness.

Talk with your doctor right away if you have close contact with someone who has 2009 H1N1 flu. You might need to take medicine to reduce your chances of getting the flu. Your doctor may prescribe Tamiflu® or Relenza® to help prevent 2009 H1N1 flu. To prevent flu, you would take a lower dose of the antiviral medicine for 10 days.

Is it safe for pregnant women to get a flu shot?
The seasonal flu shot has been given to millions of pregnant women over many years. Flu shots have not been shown to cause harm to pregnant women or their babies. The 2009 H1N1 flu shot is made in the same way and in the same places as the seasonal flu shot. It is very important for pregnant women to get both the seasonal flu shot and the 2009 H1N1 flu shot. Please see http://www.cdc.gov/h1n1flu/vaccination/ to learn more.

Who else should get a flu shot?
Anybody who will be taking care of babies younger than 6 months of age should get a seasonal flu shot and a 2009 H1N1 flu shot to protect against the flu. This includes you and any family members or other people who will be caring for your baby for the first 6 months of his or her life. Please see http://www.cdc.gov/h1n1flu/vaccination/acip.htm to learn more.

What else can I do?
Take these everyday steps to help prevent the spread of germs and protect your health and the health of your family:
• Cover your nose and mouth with a tissue when you cough or sneeze, or sneeze into your sleeve. Throw the tissue in the trash after you use it.
• Wash your hands often with soap and warm water, especially after you cough or sneeze. If soap and water are not available, an alcohol-based hand rub can be used.
• Avoid touching your eyes, nose or mouth. Germs spread this way.
• Try to avoid close contact with sick people.

o If there is 2009 H1N1 flu in your community, pay extra attention to your body and how you are feeling. If you think you have the flu, call your doctor or clinic right away.
o If you are pregnant and you live with or have close contact with someone who has 2009 H1N1 flu, talk with your doctor about medicines to prevent flu.
o Have a plan for someone else to take care of a sick family member.

• Stock up on household, health, and emergency supplies, such as acetaminophen (Tylenol®), water, and non-perishable foods.

What are the symptoms of seasonal and 2009 H1N1 flu?
You may have the flu if you have some or all of these symptoms:
• Fever*
• Cough
• Sore throat
• Runny or stuffy nose
• Body aches
• Headaches
• Chills
• Fatigue
• Sometimes, diarrhea and vomiting
*It’s important to note that some people with flu will not have a fever.

What should I do if I get sick?
If you get sick with flu-like symptoms, stay home, stay away from others, and call your doctor right away. If needed, he or she will prescribe an antiviral medicine that treats the flu. Have someone check in with you often if you are feeling ill. This is always a good idea.

How is 2009 H1N1 flu treated?
• 2009 H1N1 flu is treated with antiviral drugs such as Tamiflu® (oseltamivir) or Relenza® (zanamivir). Antiviral drugs are prescription pills, liquids or an inhaled powder that fight against the flu by keeping the germs from growing in your body. These medicines work best if they are taken as soon as you have symptoms of the flu. For that reason, it is important that you call your doctor as soon as you notice flu-like symptoms.

• If your doctor prescribes an antiviral to treat your flu, you will need to take it for 5 days. The medicine can make you get better faster and make your symptoms milder.

• At this time, there have been no reports to show harm to the pregnant woman or her unborn baby. Flu can cause serious illness and even death in pregnant women. Taking antiviral medicine can help prevent these severe outcomes.

• Antiviral medicines can be taken at any stage during pregnancy.

• Treat any fever right away. Acetaminophen (Tylenol®) is best for a pregnant woman to use to reduce a fever.

• Drink plenty of fluids to replace those you lose when you are sick.

• If you have had close contact with someone who is sick with the flu, your doctor may prescribe Tamiflu® or Relenza® to help prevent 2009 H1N1 flu. To prevent flu, you would take a lower dose of the medicine for 10 days.

• Antiviral medicines can be taken at any stage during pregnancy.

When should I get emergency medical care?
If you have any of these signs, call 911 right away:
• Difficulty breathing or shortness of breath
• Pain or pressure in the chest or abdomen
• Sudden dizziness
• Confusion
• Severe or persistent vomiting
• A high fever that is not responding to Tylenol®
• Decreased or no movement of your baby

How should I feed my baby if I am sick?
If you can, breastfeed. Breast milk is the perfect food for your baby. There are many ways that breastfeeding and breast milk protect your baby’s health. Babies who are breastfed get sick from infections like the flu less often and less severely than babies who are not breastfed.

Flu can be very serious in young babies. You do not have to stop breastfeeding if you have the flu, but you have to be careful to protect your baby from getting sick. Please see
http://www.cdc.gov/h1n1flu/infantfeeding.htm to learn more about how to feed your baby if
you are sick.


http://www.cdc.gov/h1n1flu/guidance/pregnant.htm

http://www.cdc.gov/vaccines/pubs/VIS/downloads/vis-inact-h1n1.pdf

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