Viral respiratory disease in pregnancy

Recently there has been an increased concern over viral respiratory infections and their potential for a pandemic. This concern makes it important to review the most current guidelines for the management of viral respiratory diseases in pregnancy.

The topics covered are influenza, avian influenza, and severe acute respiratory syndrome.

Pregnant women have an increased susceptibility to viral respiratory diseases. The most common respiratory virus to infect pregnant women is influenza. All women who intend to become pregnant or are pregnant should receive the influenza vaccine. If a pregnant woman develops influenza she should be treated with supportive care. Antiviral medications should be reserved for cases where the benefits outweigh the risks. Avian influenza (H5N1) is a new emerging virus usually contracted from direct contact with diseased birds. There is no commercially available vaccine at this time to prevent infection. Pregnant women should be treated aggressively with supportive care and antiviral medications, as the significant risk of maternal mortality outweighs the potential fetal risks. Pregnant women diagnosed clinically with severe acute respiratory syndrome should be treated empirically, as a serologic diagnosis can take weeks to confirm. The treatment of pregnant women with severe acute respiratory syndrome should be without ribavirin.