title: Severe 2009 H1N1 infection in early pregnancy.
abstract: OBJECTIVE
  Because pregnancy suppresses the immune system, women at any stage of pregnancy are more susceptible to bacterial and viral infection. Pregnant women might thus be at increased risk of complications from pandemic H1N1 virus infection, and illness may progress rapidly.
  
  
  METHODS
  A 23-year-old primigravida at 9 weeks' gestation was presented to our institution because of the sudden onset of sore throat, fever, chills, and vomiting for 5 days. She was diagnosed with early pregnancy H1N1 infection, vulvar herpes infection, and impending intravascular disseminated coagulopathy. Oseltamivir (Tamiflu) 75 mg and valacyclovir 500 mg were then administered orally twice daily for 5 days. The patient's fever, chills, and vomiting subsided 2 days later. The real-time reverse-transcriptase polymerase chain reaction (RT-PCR) analysis of nasal discharge for influenza virus types A and B showed positive results for the A/H1N1 influenza virus. The early pregnancy was terminated by therapeutic curettage at the patient's request. The surgical specimen revealed products of conception with the presence of necrotic chorionic villi, and focal lymphocytes in decidual tissue. RT-PCR analysis of gestational tissue for A/H1N1 was negative.
  
  
  CONCLUSIONS
  Pregnant women with H1N1 infection seem to benefit from antiviral therapy.
authors.affiliation: Department of Obstetrics and Gynecology, Kuo General Hospital, Tainan, Taiwan.
authors.forename: Guang-Qiong
authors.initials: GQ
authors.lastname: Hou
authors.forename: Yiu-Tai
authors.initials: YT
authors.lastname: Li
authors.forename: Chih-Hsing
authors.initials: CH
authors.lastname: Lin
authors.forename: Tsung-Cheng
authors.initials: TC
authors.lastname: Kuo
authors.forename: Shu-Jou
authors.initials: SJ
authors.lastname: Tasi
authors.forename: Chun-Shui
authors.initials: CS
authors.lastname: Huang
mesh_terms: D000028:Abortion, Induced; D000212:Acyclovir / Q000031:analogs & derivatives / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D004211:Disseminated Intravascular Coagulation / Q000150:complications; D005260:Female; D006558:Herpes Genitalis / Q000150:complications / Q000188:drug therapy; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000150:complications / Q000188:drug therapy / Q000821:virology*; D053139:Oseltamivir / Q000627:therapeutic use; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000821:virology*; D011261:Pregnancy Trimester, First; D000077483:Valacyclovir; D014633:Valine / Q000031:analogs & derivatives / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D053139:Oseltamivir; D014633:Valine; D000077483:Valacyclovir; D000212:Acyclovir