Saturday, December 15, 2012

Treatment of the Flu in Pregnancy

I treated my first influenza patient of the year this season. Even though she and her son received the flu vaccine they still contracted the flu. This unfortunately can happen and made me review the treatment guidelines for pregnant patients.

Pregnant patient and patients up to 2 weeks after delivery or miscarriage are considered high risk for complications of the flu. They are much more likely to need hospitalization , admission to the ICU and even death.

Therefore early empiric treatment for patient with flu symptoms including fever, respiratory symptoms and muscle aches. The earlier the treatment the more benefit is seen from the medications. ( Treatment within 2-4 days of onset of symptoms is preferred.)

Treatment with Osetamivir (Tamiflu) is preferred in pregnancy. This medication is considered Cat C because it has not been tested in pregnancy. Extensive use though has not found it not to cause harm.

Treatment of fever over 100.5 is recommended with Tylenol. Advil and aspirin are not recommended in pregnancy. High fever in pregnancy has been associated with birth defects in the first trimester.

If you are experiencing flu symptoms especially if you have a known household contact known to have the flu, please contact our office within two days.

We have recently obtained the Rapid Flu and Rapid Strep tests in our offices and can offer you empiric treatment until results obtained or an appointment is made.

Please notify our front desk personnel  immediately if you have fever and flu symptoms so we can isolate you from our other healthy OB patients.

Wednesday, December 12, 2012

Travel in Pregnancy

We are getting lots of questions with the upcoming holidays about travel during pregnancy.  Most airlines limit international/overseas travel to 32 weeks and domestic travel to 36 weeks of pregnancy.  Most cruise ships limit travel to 26 weeks or even less (be sure to check with your cruise line).  This is of course assuming everything in the pregnancy is going well.  Hi blood pressure, preterm contractions, bleeding or twin pregnancies would be a different story potentially.  The biggest risk with long trips in pregnancy is the increased risk of blood clots in the legs or pelvis which can break off and travel to the lungs, causing pulmonary embolus.  We recommend frequent breaks for a walk, avoiding crossing your legs, good hydration and maybe even anti-embolism stockings (medium strength) that can be found at better pharmacies.