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Open Access Case Report

Maternal and fetal recovery after severe respiratory failure due to influenza: a case report

Kristine Madsen1*, Ditte Gry Strange2, Morten Hedegaard1, Elisabeth R Mathiesen3 and Peter Damm1

Author affiliations

1 Department of Obstetrics, Center for Pregnant Women with Diabetes, The Juliane Marie Centre, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark

2 Department of Anesthesiology, Center for Pregnant Women with Diabetes, The Juliane Marie Centre, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark

3 Department of Endocrinology, Center for Pregnant Women with Diabetes, The Juliane Marie Centre, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark

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Citation and License

BMC Research Notes 2013, 6:62  doi:10.1186/1756-0500-6-62

Published: 15 February 2013

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.

Case presentation

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.

Conclusion

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.

Keywords:
Pregnancy; Diabetes; Influenza; Pneumonia; Mechanical ventilation; Pregnancy outcome