Longman Ryan E, Johnson Timothy R B
Obstetrics and Gynecology, University of Michigan, Women's Hospital, Ann Arbor, Michigan 48109, USA.
Curr Opin Obstet Gynecol. 2007 Apr;19(2):120-5. doi: 10.1097/GCO.0b013e328028fdc7.
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.
近期，人们对病毒性呼吸道感染及其引发大流行的可能性愈发关注。这种关注使得回顾当前妊娠期病毒性呼吸道疾病管理的最新指南变得至关重要。
涵盖的主题包括流感、禽流感和严重急性呼吸综合征。
孕妇对病毒性呼吸道疾病的易感性增加。感染孕妇最常见的呼吸道病毒是流感。所有打算怀孕或已怀孕的女性都应接种流感疫苗。如果孕妇患上流感，应给予支持性治疗。抗病毒药物应仅用于获益大于风险的情况。禽流感（H5N1）是一种新出现的病毒，通常通过直接接触病禽感染。目前尚无预防感染的商用疫苗。孕妇应积极接受支持性治疗和抗病毒药物治疗，因为孕产妇死亡的重大风险超过了潜在的胎儿风险。临床诊断为严重急性呼吸综合征的孕妇应进行经验性治疗，因为血清学诊断可能需要数周才能确诊。患有严重急性呼吸综合征的孕妇治疗时不应使用利巴韦林。
