From the Guidelines
Pregnant patients with influenza A should be treated with antivirals as soon as possible.
Management of Influenza A in Pregnant Patients
- The patient in question, who is 12 weeks and 5 days pregnant with myalgias and pyrexia due to Influenza A, should receive antiviral treatment, as pregnancy is considered a high-risk condition for complications from influenza 1.
- Oseltamivir is the preferred antiviral medication for treatment of pregnant women, although zanamivir may be considered in some cases 1.
- The same antiviral dosing as nonpregnant persons is recommended for pregnant women 1.
- Treatment should not be delayed while waiting for diagnostic test results, and empiric antiviral treatment is often necessary 1.
- Acetaminophen can be used to treat fever in pregnant women with influenza, as reducing fever may help reduce the risk of adverse fetal outcomes 1.
- The patient should receive a full treatment course of antiviral medication, regardless of negative initial test results, unless an alternative diagnosis can be established and clinical judgment suggests that influenza is unlikely 1.
From the Research
Management of Influenza A in Pregnancy
The management of a pregnant patient at 12 weeks and 5 days gestation with myalgias and pyrexia due to Influenza A involves the following:
- Treatment with antivirals, specifically oseltamivir, which is the mainstay of treatment and prophylaxis 2
- Early treatment with oseltamivir, ideally within 48 hours of symptom onset, to decrease morbidity and mortality 2, 3, 4
- Diagnostic testing is not necessary for patients with flu-like symptoms or flu exposure 2
Benefits of Early Treatment
Early treatment with oseltamivir has been shown to:
- Reduce the risk of severe disease 3, 4
- Decrease maternal and neonatal morbidity 4
- Lower the risk of premature birth 5