Turgut TEKE, Emin MADEN, Kazım GEZGİNÇ, Ümmiye DURAN, Mehnet D. YAVŞAN, Kürşat UZUN

A pregnant case with severe influenza A (H1N1) virus infection-related ARDS

Gebe kadınlar gribe daha duyarlıdırlar ve hastalık bu kişilerde daha şiddetli olabilmektedir. Biz bu makalede şiddetli H1N1 enfeksiyonu nedeniyle ARDS gelişen 37 yaşında gebe bir hastayı sunduk. Otuz yedi yaşında 36 haftalık gebe bayan hasta YBÜ’mize hızla kötüleşen nefes darlığı şikâyeti ile yatırıldı. Yatışta taşikardisi, takipnesi ve şiddetli hipoksemisi (PaO2/FiO2=104) vardı. Hastaya H1N1 enfeksiyonu ile ilişkili ARDS tanısı konuldu. Oseltamivir, geniş spektrumlu antibiyotikler, bronkodilatörler ile birlikte NİV tedavisi başlandı. Nazofaringeal sürüntüsünde H1N1 pozitifti. Bir gün sonra hipoksemisi daha da derinleşmesi üzerine hasta entübe edilerek MV’e bağlandı ve eş zamanlı olarak acil sezeryan operasyonuna verildi. Operasyonla sağlıklı bir erkek çocuğu doğurdu. Daha sonra hastanın klinik durumu hızla düzeldi. H1N1 enfeksiyonu nedeniyle ARDS gelişen gebe kadınlar oseltamivir ve mekanik ventilasyonla başarılı bir şekilde tedavi edilebilir.

Şiddetli influenza A (H1N1)'ya bağlı ARDS gelişen gebe

Pregnant women are more susceptible to influenza and pregnancy may enhance the severity of the illness. In this article, we reported a 37-year-old pregnant woman with ARDS related to severe influenza A (H1N1) virus infection. A 37-year-old pregnant woman at 36 weeks gestation was admitted to our ICU with rapidly worsening dyspnoea. She had tachycardia, tachypnoea and severe hypoxia (PaO2/FiO2=104). A diagnosis severe H1N1 infection-related ARDS was made and treated with oseltamivir, broad-spectrum antibiotics, bronchodilators and NIV. Her nasopharyngeal swab was positive for H1N1. One day later, her hypoxia remained severe, and she was intubated and MV was commenced. Simultaneously, the patient gave birth to a healthy boy by emergency cesarean delivery. Her condition gradually improved. Pregnant women with severe H1N1 infection-related ARDS may be successfully treated with oseltamivir and mechanical ventilation.

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