Retrospective analysis of maternal and foetal outcome of H1N1 influenza amongst antenatal mothers at a tertiary care hospital

Abstract

Background: Pregnancy is an immunocompromised state where in infections are common. H1N1 (hemagglutinin type 1 and neuraminidase type 1) Influenza is a seasonal epidemic, considered as an alarming infection across the world with high rates of maternal mortality each year. The principal intention of this study was to elicit the clinical profile of antenatal mothers with H1N1 and subsequently to analyse the risk factors, prognosis and the materno-fetal outcome. Extensive review of literature with current guidelines and management protocols has been highlighted. Methodology: This is a retrospective observational study performed in Sri Ramachandra University and Research Institute over the period of one year from January 2016 – March 2017, the clinical course of the patients who were confirmed with H1N1 influenza using throat swab RT-PCR assay was analysed. Statistical analysis was done by SPSS, version 11. Results: A total of 62 antenatal patients with symptoms suggestive of H1N1 influenza were tested for H1N1 out of which 12 were positive, which accounted for 19.35% positivity. The mean age was 24 years with a range of 22-30 years. The epidemic peaked in the month of November to January. Fever with cough was the most common clinical manifestation. Most of the patients were hospitalized and treated with oseltamivir. All the positive patients, were advised home isolation for 5-7 days after discharge. This indexed study had an overall mortality rate of 8.3%. Acute respiratory distress syndrome and multiple organ dysfunction were the most common cause of death. Conclusion: Most of the patients recuperated well with close vigilance, symptomatic and antiviral treatment, went on to deliver healthy baby. Proper prevention steps, personal hygiene and admission to designated swine flu ward can be helpful in preventing the spread in the community. Respiratory failure and sepsis were the cause of mortality among the patients of this study.