A host of factors combine to make the flu particularly hazardous for pregnant women. For one thing, when you're pregnant, your immune system is suppressed, making it more likely that you'll catch whatever virus is currently making the rounds. For another, a growing uterus compromises respiratory capacity. As a result, pregnant women are more likely to experience a severe form of almost any illness — and influenza in particular. But should you go to the hospital if you get the flu while pregnant? While you might not be admitted, you will need to take an antiviral to prevent the disease from worsening, and doctors will want to monitor your symptoms closely. However, if you develop influenza pneumonia as a result of the flu, the hospital is the safest place for you to be.
"During the H1N1 pandemic in 2009, pregnant women were overrepresented in the numbers of the dead," explains Amesh Adalja, MD, who studies pandemics and infectious diseases at the Johns Hopkins Center for Health Security. H1N1 was a serious case, but Adalja's words drive home exactly how crucial it is to seek treatment — at the hospital, or from your OB-GYN — if you're sick. "In pregnant women, there's basically no threshold [for waiting]. They need to see a provider, and they need to be on antivirals ... some of these women may be admitted, some may take antivirals at home, but it's important they seek medical attention." If your OB-GYN can't see you right away, they should direct you to the nearest hospital. In pregnancy especially, treating the flu is time sensitive.
Pregnant or postpartum women should call their OB-GYN right away if they develop a fever combined with respiratory illness, because antivirals like Tamiflu are most effective if administered within two days of the onset of symptoms, explains James Byers, MD, an OB-GYN with the Division of Maternal Fetal Medicine, Einstein Medical Center Philadelphia. "Patients with the flu who develop shortness of breath should come to the hospital to rule out influenza pneumonia." Truly, an infection is not something to take lightly. Even healthy pregnant women are five times as likely to die from flu than others in the population, according to Byers.
What about the flu's effects on a developing baby? An infection in the first trimester is associated with a three-fold increase of spina bifida, and an incredible five-fold increase in hydrocephaly, notes Byers. First trimester flu also increases your chance of miscarriage, according to the March of Dimes. "Influenza pneumonia in the second and third trimester can lead to fetal hypoxia and need for premature delivery," Byers explains.
Of course, the absolute best way to prevent the flu is to get vaccinated with an inactive version of the virus. Unfortunately, the vaccine can't offer perfect protection — as Adalja explains, the shot is only 65 percent effective during the best years — but that doesn't mean you should skip it. "You might still get the flu," Adalja notes. "But the flu you get when vaccinated tends to be less severe than if you weren’t." The Centers for Disease Control and Prevention (CDC) currently recommends that all pregnant women get vaccinated regardless of trimester.
Vaccination can also help you avoid the hospital, and according to Dr. Ian Tong, Chief Medical Officer at video medicine provider Doctor On Demand, that's a good thing all on its own. "Emergency rooms and hospitals are home to some of the most dangerous bacteria on the planet, so avoid these sites if possible." (Of course, if your symptoms are severe, the hospital is the only place you should be.) Tong further notes that mothers who vaccinate during pregnancy provide protection from the flu to their newborns as well, for at least a few months after birth, through a phenomenon known as "passive immunity."
Bottom line: the flu is extremely dangerous, both to you and your developing baby. You should never put off treatment if you suspect you have the flu, and you should start antivirals as soon as possible. Dehydration, severe fatigue, or shortness of breath can easily land you in the hospital, where you'll likely get checked out for influenza pneumonia. Basically, this is not a chicken soup and Netflix situation. The flu is a serious, aggressive virus that is especially dangerous during pregnancy. If your doctor can't see you in a timely manner, you should head to the hospital for an evaluation right away. To prevent such a crisis, ask you OB-GYN about a flu shot, and get the rest of your family vaccinated for good measure.
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