Obstet Gynecol. 2018 Oct;132(4):e169-e173. doi: 10.1097/AOG.0000000000002872.
Pregnant and postpartum women are at high risk of serious complications of seasonal and pandemic influenza infection. Pregnancy itself is a high-risk condition, making the potential adverse effects of influenza particularly serious in pregnant women. If a pregnant woman has other underlying health conditions, the risk of adverse effects from influenza is even greater. Antiviral treatment is necessary for all pregnant women with suspected or confirmed influenza, regardless of vaccination status. Obstetrician-gynecologists and other obstetric care providers should promptly recognize the symptoms of influenza, adequately assess severity, and readily prescribe safe and effective antiviral therapy for pregnant women with suspected or confirmed influenza. Over-the-phone treatment for low-risk patients is preferred to help reduce the spread of disease among other pregnant patients in the office. Obstetrician-gynecologists and other obstetric care providers should treat pregnant women with suspected or confirmed influenza with antiviral medications presumptively based on clinical evaluation, regardless of vaccination status or laboratory test results. Pregnant women with suspected or confirmed influenza infection should receive antiviral treatment with oseltamivir or zanamivir based on the current resistance patterns. Treatment within 48 hours of the onset of symptoms is ideal but treatment should not be withheld if the ideal window is missed. Because of the high potential for morbidity and mortality for pregnant and postpartum patients, the Centers for Disease Control and Prevention advises that postexposure antiviral chemoprophylaxis can be considered for pregnant women and women who are up to 2 weeks postpartum (including after pregnancy loss) who have had close contact with infectious individuals.
孕妇和产后妇女患季节性和大流行性流感感染的严重并发症的风险很高。怀孕本身就是一种高危情况，这使得流感对孕妇的潜在不良影响尤为严重。如果孕妇有其他潜在的健康状况，那么流感的不良影响风险更大。所有疑似或确诊流感的孕妇都需要进行抗病毒治疗，无论其疫苗接种状况如何。妇产科医生和其他产科护理提供者应及时识别流感症状，充分评估严重程度，并为疑似或确诊流感的孕妇开具安全有效的抗病毒治疗药物。对于低危患者，电话治疗是首选，以帮助减少办公室中其他孕妇之间的疾病传播。妇产科医生和其他产科护理提供者应根据临床评估，对疑似或确诊流感的孕妇进行抗病毒药物治疗，而不考虑疫苗接种状况或实验室检测结果。疑似或确诊流感感染的孕妇应根据当前耐药模式接受奥司他韦或扎那米韦的抗病毒治疗。在症状出现后 48 小时内进行治疗是理想的，但如果错过了理想的治疗窗口，也不应拒绝治疗。由于孕妇和产后患者的发病率和死亡率很高，疾病预防控制中心建议对有密切接触传染性个体的孕妇和产后 2 周内（包括流产后）的妇女进行接触后抗病毒化学预防。
