ACOG Committee Opinion: Rx of pregnant women with suspected
In a recently released committee opinion, the American College of Obstetricians and Gynecologists (ACOG) has issued recommendations for the assessment and treatment of pregnant women with suspected or confirmed influenza.

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.

The recommendations are:-
• 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.

• 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.

• Based on previous influenza seasons, oseltamivir is the preferred treatment for pregnant women (75 mg orally twice daily for 5 days) assuming there is sufficient supply and the prevalence of resistant circulating viruses is low. Zanamivir also may be prescribed (two 5-mg inhalations [10 mg total] twice daily for 5 days), or alternatively peramivir may be administered (one 600-mg dose by intravenous infusion for 15–30 minutes).

• Pregnant women who are not identified as high or moderate risk of complications but have symptoms suggestive of influenza infection can be prescribed antiviral treatment over the phone or in person in accordance with Centers for Disease Control and Prevention (CDC) guidelines.

• Pregnant women without high-risk symptoms but with comorbidities (eg, asthma), obstetric issues (eg, preterm labor), or who are unable to care for themselves (eg, obtain prescription medications or unable to tolerate oral intake) should be seen as soon as possible in an ambulatory setting with resources to determine the severity of illness.

• Because of the high potential for morbidity and mortality for pregnant and postpartum patients, the CDC 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.

About ACOG
Founded in 1951, the American College of Obstetricians and Gynecologists is the speciality's premier professional membership organization dedicated to the improvement of women’s health. With more than 58,000 members, the College is a 501(c)(6) organization and its activities include producing the College's practice guidelines and other educational material.

Note: This list is a brief compilation of some of the key recommendations included in the guidelines and is not exhaustive and does not constitute medical advice. Kindly refer to the original publication here: https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Immunization-Infectious-Disease-and-Public-Health-Preparedness-Expert-Work-Group/Assessment-and-Treatment-of-Pregnant-Women-With-Suspected-or-Confirmed-Influenza
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Dr. H●●●●h D●●●i
Dr. H●●●●h D●●●i Obstetrics and Gynaecology
Important in view of current epidemic of Swine-Flu.
Oct 2, 2018Like1