In pregnant women development of serious complications, higher hospitalization rates , and difficulties encountered in the management of pulmonary failure due to pandemic Influenza A (H1N1-2009) infection have been reported. In this case report diagnostic and therapeutic work-up of a pregnant woman who had congenital kyphoscoliosis and developed serious pneumonia and ARDS after Influenza A (H1N1) viral infection were described. Ampicillinsulbactam, azithromycin, oseltamivir and bronchodilator treatment was begun for 29-year-old woman at 31 weeks of twin pregnancy with initial diagnoses of community-acquired or influenza pneumonia. Emergency cesarean delivery was performed due to worsening in her general health state, consciousness and arterial blood gas values in the fourth day of the treatment. Following operation, her respiratory failure persisted, and the entubated patient was taken to the intensive care unit. She was followed-up at SIMV, PSV-CPAP modes intermittently without achievement of sufficient tidal levels, so permissive hypercapnia was administered. She was extubated on the 19th day of respiratory support treatment, and discharged from hospital on 29th day of her admission to the reanimation unit. Our patient was in high risk group for pandemic Influenza A infection (HINI-2009) because of pregnancy and kyphoscoliosis. We consider that early hospitalization, antimicrobials, and respiratory support treatments have prevented mortality.
Keywords: Influenza A virus H1N1 subtype, pregnancy, respiratory failure