If you are pregnant, you are in one of the high-risk groups for swine flu, so it is important to read this page carefully and follow the advice to protect yourself and your baby.
This page explains why pregnant women are at greater risk from swine flu, what those risks are, the special precautions you should take and the safety information for swine flu treatments.
Why pregnant women are more at risk
In pregnancy, the immune system is naturally suppressed. This means that pregnant women are more likely to catch swine flu, and if they do catch it, they are more likely to develop complications (see below).
Don't panic: your immune system still functions and the risk of complications is very small. Most pregnant women will only have mild symptoms.
Symptoms and risks
If you are pregnant and you catch swine flu, the symptoms should be similar to those of regular flu. You will typically have a fever or high temperature (over 38°C/100.4°F) and two or more of the following:
- unusual tiredness,
- headache,
- runny nose,
- sore throat,
- shortness of breath or cough,
- loss of appetite,
- aching muscles,
- diarrhoea or vomiting.
Most pregnant women will have only mild symptoms and recover within a week. However, there is evidence from previous flu pandemics that pregnant women are more likely to develop complications.
Possible complications are:
- pneumonia (an infection of the lungs),
- difficulty breathing, and
- dehydration.
In pregnant women, these are more likely to happen in the second and third trimester.
If a pregnant woman develops a complication of swine flu, such as pneumonia, there is a small chance this will lead to premature labour or miscarriage. There is not yet enough information to know precisely how likely these birth risks are.
It is therefore important to be well prepared and to take precautions against swine flu.
Special precautions
If you are pregnant, you can reduce your risk of infection by avoiding unnecessary travel and avoiding crowds where possible.
Pregnant women should also follow the general advice outlined in the box, top right. Good hygiene is essential.
If a family member or other close contact has swine flu, your doctor may prescribe you antiviral medication (usually Relenza) as a prophylactic (preventative) measure.
If you think that you may have swine flu, call your doctor for an assessment immediately. If your doctor confirms swine flu over the phone, you will be prescribed antiviral medication to take as soon as possible (see box, left).
Unless you have swine flu symptoms, carry on attending your antenatal appointments to monitor the progress of your pregnancy.
Swine flu treatment
Antivirals
If you are pregnant and diagnosed with swine flu, you will usually be given a course of antiviral drugs, which should be taken as soon as possible.
If you have an uncomplicated illness due to influenza and do not have an underlying disease, you can take either Relenza or Tamiflu. Relenza is recommended as first choice.
Relenza is inhaled using a disk-shaped inhaler. It is recommended for pregnant women because it easily reaches the throat and lungs, where it is needed, and does not reach significant levels in the blood or placenta. Relenza should not affect your pregnancy or your growing baby.
However, Tamiflu should be offered to you instead of Relenza if you:
- have a condition such as asthma or chronic obstructive pulmonary disease,
- have difficulty taking an inhaled antiviral, or
- develop a severe or complicated disease due to influenza (where you will probably be treated in hospital).
An expert group reviewed the risk of antiviral treatment in pregnancy. It is much smaller than the risk posed by the symptoms of swine flu.
Some people have had wheezing or serious breathing problems when they have used Relenza. Relenza is therefore not recommended for people with asthma or chronic obstructive pulmonary disease (COPD). Other possible side effects include headaches, diarrhoea, nausea and vomiting.
In a small number of cases, nausea is a side effect of Tamiflu.
If you take an antiviral and have side effects, see your healthcare professional to check that you are OK. Then report your suspected drug reaction to the Medicines and Healthcare products Regulatory Agency (MHRA) using their new online system.
Painkillers
You can also take paracetamol to reduce fever and other symptoms; this is safe to take in pregnancy.
However, pregnant women should not take non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Nurofen).
Vaccination and pregnancy
Pregnant women are in one of the groups who will be offered the swine flu vaccination first. The vaccine is recommended for all pregnant women, whatever the stage of the pregnancy.
There is no evidence that inactivated vaccines, such as the swine flu vaccine, will cause any harm to pregnant women or their unborn baby. Every year, the seasonal flu vaccine is given to pregnant women who are at risk of seasonal flu.
The Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency has given a clear recommendation that the GlaxoSmithKline vaccine Pandemrix can be given safely to all pregnant women.
The Department of Health have recently published an information briefing on vaccination and pregnancy.
For more information and advice see 'Vaccination and pregnancy'.
Information resources
Further reliable information on swine flu is available from the following sources:
Flu service: QA
QAs on pregnancy and children
Advice from the chief medical officer
Royal College of Obstetricians and Gynaecologists: advice for pregnant women
Information on Relenza
Department of Health: maternal and infant nutrition
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