Influenza in pregnancy. Is it dangerous and how is it treated?

Influenza is a highly infectious viral disease. Children, adults, the elderly and even pregnant women cannot escape it during an outbreak.

It can be mild, but it can also have complications.

In pregnancy, it is dangerous mainly because of the complications it can cause. Therefore, prevention is important during pregnancy and, in the event of an outbreak, treatment with regard to pregnancy.

What makes pregnancy specific?

The period of pregnancy is also specific for the immune system.

Certain components of the immune system are suppressed. However, the components of the natural immunity are strengthened.

Immunity adapts to the period of pregnancy. The main reason is that it does not attack the fetus and cause its death. The type of immunity that is suppressed is mainly effective against the multiplication of viruses inside the cell. This plays in favour of certain diseases and also in favour of the flu.

If it proceeds mildly, without complications, there is no cause for increased concern.

Caution should be exercised when the course is more severe and when more serious problems occur.

Everyone's immune system is different. We all cope with flu differently. The same is true during pregnancy.

The health of the mother is at risk, but also that of the unborn child.

For the mother, the most critical period is the third trimester.

According to the Hungarian survey, the risks arising from the disease show that the second and third trimesters are prone to the development of birth defects in children. These include cleft lip and palate, neural tube defect, and diseases of the cardiovascular system.

The incidence of these defects has been reduced by the administration of antipyretics, which are antipyretic drugs. A more severe course may also account for premature birth or low birth weight of the newborn.

For the mother as well as for the fetus, respiratory failure (respiratory insufficiency) is serious. With respiratory insufficiency, the fetus is at risk of a reduced oxygen supply.

Diseases that worsen the course:

• pneumonia (pneumonia - viral or secondary to bacteria).
• asthma
• chronic obstructive bronchopulmonary disease
• and other chronic diseases (diabetes, weakened immunity)

Treatment of influenza

Treatment of influenza is mostly symptomatic, which means that medicines are given to counteract the symptoms caused by the flu. Medicines that are effective against the influenza virus (antivirals) are only given to those at risk and in severe cases.

During pregnancy, the use of medicines is restricted because of the risks to the baby.

Some fever-reducing drugs are safe, such as some antibiotics. Others can only be given during certain periods of pregnancy.

There are medicines that can be given with the acceptance of certain risks to the fetus. There are also those that are prohibited altogether (before pregnancy, during pregnancy and after birth in the case of breastfeeding). In any case, leave the choice of medicines to the doctor.

The table gives information on some medicines for various conditions in relation to the period of pregnancy

Body temperature during pregnancy should not exceed 38 °C in order not to endanger the health and life of the fetus.

You can try a wrap, a shower or anti-fever medication (antipyretics).

If you have a sore throat, you can gargle a salty solution and try humidifying the air. For sinusitis, try steaming. The table below shows which medicines and other preparations for associated symptoms are safe and which are not in pregnancy.

Supportive treatment during flu is basically based on adequate fluid intake, increased consumption of fruits and vegetables for vitamin content. Vitamin C (daily dose 500 mg) and zinc play a major role.

Rest and bed rest is important. For better respiratory relaxation, a semi-sitting position is better. Ventilate the room more. Increased hygiene is equally important as prevention.

To recap, let's recall the symptoms of flu:

• Increase in body temperature to fever (38-40 °C)
• Chills, shivering
• Sweating
• General weakness, fatigue, malaise
• Headache
• Pain in joints, muscles, limbs
• Rhinorrhea
• Sore throat
• Cough, irritating, dry, choking
• Chest pain, especially when coughing
• Eye irritation, painful eye movements
• Nausea, nausea, vomiting and other intestinal forms (also diarrhoea)
• Indigestion

In severe life-threatening situations, termination of pregnancy may be indicated to save the health and life of the pregnant woman and, depending on the week of pregnancy, to save the life of the unborn child.

When is a medical examination necessary?

If a pregnant woman becomes ill with influenza, it is important to monitor her health. If the following symptoms are associated, a medical examination is necessary.

Warning signs that require immediate professional help:

• difficulty breathing, shallow breathing.
• chest tightness (or other chest pain)
• abdominal pain
• the child's movements may be muffled or even absent
• high fever
• disorientation, confusion
• prolonged, severe vomiting
• dizziness

What is the possibility of prevention?

Prevention is best for a pregnant woman.

This can include an increased intake of vitamins in the diet or even in the form of nutritional supplements designed for the period of pregnancy. Of the vitamins, it is mainly vitamin C and D.

Minerals such as zinc are also beneficial in prevention, but also in treatment. Preventive measures could also include the use of probiotics.

Interesting information:
Health effects of vitamin D
Probiotics and their importance for human health

During the seasonal period of increased influenza incidence, it is recommended to limit movement in places such as shopping malls and other places with a mass presence of people. Influenza is highly infectious and is transmitted by droplet infection, by talking, coughing, sneezing, but also by direct contact, such as shaking hands.

Don't touch your eyes, nose or mouth. That's the way the virus enters the body.

Hence the need for increased hygiene. Hand washing and the use of appropriate products. It is also important to take extra care of our surroundings, such as washing door handles, switches and other surfaces that we touch frequently.

Vaccination

During pregnancy, vaccination is recommended before the main influenza season (October to December). Vaccines are adjusted annually according to the World Health Organization (WHO).

The vaccines contain non-living parts of the virus that are safe for pregnancy.

The flu vaccine is also safe before and during pregnancy and there is no problem with vaccination after birth. Part of the immunity is also passed on to the baby in the womb.

After birth, it is also passed on in breast milk through breastfeeding. This provides protection from the disease for the baby as well.

Vaccines containing live particles are prohibited during pregnancy.

If you are unsure or worried, it is of course better to consult a doctor.

In 1999, the World Health Organization (WHO) established the Strategic Advisory Group of Experts SAGE on Immunization, which is responsible for vaccines and immunization research, development and delivery.

WHO SAGE recommends influenza vaccination for the following populations:

• pregnant women in any month of pregnancy
• children from six months of age, preschool and school age
• healthcare workers and other staff working in healthcare settings who are in contact with patients
• workers in ministries who come into close contact with many people (teachers, bank, shop, post office and transport staff)
• soldiers, police officers
• active sports people
• people aged 59 and over and their family members
• people with chronic diseases (cardiovascular, respiratory, kidney, metabolic diseases, immune disorders) and their family members

During the course of the disease, the content of particles in 1 ml of secretion is more than a million and only a few dozen are needed to become infected.

Prevention is important. But it doesn't always guarantee protection against flu.

If a pregnant woman notices symptoms on herself that could indicate a flu-like illness, it is important to contact a doctor. He or she will recommend a course of action.

Pregnancy is a period when any deterioration in health can mean its endangerment or even termination. It all depends on the illness that occurs during this period. Flu is one of those in which caution should be exercised.