Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341-3717, USA.
Am J Obstet Gynecol. 2011 Jun;204(6 Suppl 1):S21-30. doi: 10.1016/j.ajog.2011.02.038. Epub 2011 Apr 22.
We sought to describe the characteristics and clinical management of 71 critically ill pregnant women with pandemic 2009 influenza A (H1N1 [2009 H1N1]). This was a retrospective case series from April 23, 2009, through March 18, 2010, of pregnant women with 2009 H1N1 in intensive care units in California. Among 71 critically ill pregnant women with 2009 H1N1, rapid decline in clinical status was noted with a median duration of 1 day from hospital admission to intensive care unit admission. Adverse events were common, and included sepsis (n = 26), hematologic disorder (n = 17), and pneumothorax (n = 15). Of 42 women requiring invasive ventilation, 15 (36%) died. In total, 23 women required rescue therapies for severe gas exchange abnormalities. Adverse events were significantly associated with survival (P = .0003). Women who received early antiviral treatment were significantly more likely to survive (relative risk, 1.43; 95% confidence interval, 1.18-1.75). Critically ill pregnant women with 2009 H1N1 declined rapidly and developed frequent adverse events including death.
我们旨在描述 71 例重症妊娠合并 2009 年甲型 H1N1 流感（2009 H1N1）患者的临床特征和诊疗管理方法。这是 2009 年 4 月 23 日至 2010 年 3 月 18 日加利福尼亚州重症监护病房中妊娠合并 2009 H1N1 患者的回顾性病例系列研究。在 71 例重症妊娠合并 2009 H1N1 患者中，从入院到入住重症监护病房，临床状态迅速恶化，中位时间为 1 天。不良事件很常见，包括败血症（n = 26）、血液系统疾病（n = 17）和气胸（n = 15）。需要有创通气的 42 名女性中，有 15 名（36%）死亡。共有 23 名女性需要抢救治疗以纠正严重的气体交换异常。不良事件与存活率显著相关（P =.0003）。接受早期抗病毒治疗的女性存活率显著更高（相对风险，1.43；95%置信区间，1.18-1.75）。重症妊娠合并 2009 H1N1 的患者病情迅速恶化，且常发生不良事件，包括死亡。
