Beigi, R. H. (2007). Obstetrics & Gynecology, 109, 1193-1196.

Influenza pandemics, although unpredictable, tend to occur at 20- to 40-year intervals. In the 20th century there were three pandemics, which occurred in 1918, 1957, and 1968. Because of the natural evolution of influenza viruses, it is predicted that we are due for another pandemic. The Avian flu virus (H5N1) is a likely candidate for such a pandemic. The Avian flu, to date, has been reported to have a 60.2% mortality rate among the 267 proven cases of human infection. This is of concern to obstetric healthcare providers because in the past, pregnant women suffered excess morbidity from influenza. In maternity units, it is possible that the admission of a woman with the flu would pose significant transmission to already hospitalized patients. We also could expect to see an increase in the preterm delivery rate.

It is important for obstetric care providers and institutions that provide perinatal care to become actively involved in planning to deal with an influenza pandemic. For example, if a hospital unit has patients with influenza, effective communication efforts to other patients must be in place so that uninfected women stay away from these units unless absolutely necessary. Within hospitals, planning should occur so that critically ill pregnant women can be cared for in areas of the hospital that are separated from units in which noninfected women are housed. Supplies should be stockpiled, and plans need to be made for coping with staffing changes that may be necessary because of worker shortages due to individual and familial illness. The pregnant population is of special concern because unlike elective surgery, labor and delivery cannot be postponed.

Judith A. Lewis