title: Maternal and fetal recovery after severe respiratory failure due to influenza: a case report.
abstract: BACKGROUND
  During pregnancy women are at increased risk of severe complications to influenza infection, including death of mother or fetus, especially if chronic comorbid medical conditions such as diabetes mellitus are present.
  
  
  METHODS
  A 36 years old Caucasian pregnant woman with type 1 diabetes underwent mechanical ventilation in gestation week 27 for severe respiratory failure due to influenza and pneumonia. For three weeks during and following her most severe illness, fetal growth could not be detected and the umbilical flows and amniotic fluid volumes were affected too. The possibility of preterm delivery and extracorporeal membrane oxygenation (ECMO) treatment were considered, however the patient and her fetus recovered gradually on conservative treatment. Under close surveillance the pregnancy continued until term, with delivery of an infant with appropriate weight for gestational age.
  
  
  CONCLUSIONS
  Preterm delivery and decreased birth weight were reported for women with antepartum pneumonia. Mechanical ventilation and ECMO treatment for severe respiratory failure in pregnancy are life threatening conditions and have been associated with preterm delivery. It remains uncertain if delivery improves the respiratory status of a critically ill woman, and the fetal condition is likely to improve, if the maternal condition is stabilized.Severe respiratory insufficiency requiring mechanical ventilation in a diabetic pregnant woman with influenza was successfully treated conservatively. Despite clear signs of impaired fetal condition in the acute phase, watchful waiting resulted in delivery of a normal weight infant at term.
authors: Department of Obstetrics, Center for Pregnant Women with Diabetes, The Juliane Marie Centre, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark. kmadsen1979@gmail.com
authors: Kristine
authors: K
authors: Madsen
authors: Ditte Gry
authors: DG
authors: Strange
authors: Morten
authors: M
authors: Hedegaard
authors: Elisabeth R
authors: ER
authors: Mathiesen
authors: Peter
authors: P
authors: Damm
mesh_terms: D000328:Adult; D005260:Female; D005333:Fetus / Q000503:physiopathology*; D006801:Humans; D007251:Influenza, Human / Q000150:complications / Q000503:physiopathology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000534:rehabilitation*; D012131:Respiratory Insufficiency / Q000209:etiology*