{"id":17682,"date":"2026-03-03T00:29:06","date_gmt":"2026-03-02T23:29:06","guid":{"rendered":"https:\/\/valintermed.com\/?p=17682"},"modified":"2026-03-03T00:29:06","modified_gmt":"2026-03-02T23:29:06","slug":"gripp-u-beremennyh-riski-dlya-mamy-i-rebyonka-bezopasnoe-lechenie","status":"publish","type":"post","link":"https:\/\/valintermed.com\/en\/medlibrary\/flu-in-pregnant-women-risks-for-mother-and-child-safe-treatment\/","title":{"rendered":"Influenza in pregnant women: risks for mom and baby, safe treatment"},"content":{"rendered":"<div class=\"fpm_start\"><\/div>\n<p>Influenza in pregnant women is not just a \"cold with a fever,\" but a serious viral disease that can cause complications for both the future mother and the child. The influenza virus attacks the respiratory tract, causing fever, aches, cough, and weakness, but during pregnancy, these symptoms can lead to much more dangerous consequences: pneumonia, premature birth, low birth weight, or even intrauterine hypoxia. A woman's body during pregnancy is in a special physiological state: the immune system intentionally \"slows down\" to avoid rejecting the fetus. This makes her vulnerable to infections\u2014especially acute respiratory viruses, including influenza. And while a healthy person usually recovers in 7-10 days, the risk of complications increases significantly for pregnant women. The third trimester and the first weeks after childbirth are particularly dangerous\u2014this is when the load on the cardiovascular and respiratory systems is at its maximum.<\/p>\n<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_83 counter-flat ez-toc-counter ez-toc-light-blue ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Content<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewbox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewbox=\"0 0 24 24\" version=\"1.2\" baseprofile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 eztoc-toggle-hide-by-default' ><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/flu-in-pregnant-women-risks-for-mother-and-child-safe-treatment\/#%D0%9A%D0%BB%D0%B0%D1%81%D1%81%D0%B8%D1%84%D0%B8%D0%BA%D0%B0%D1%86%D0%B8%D1%8F_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D0%BF%D0%BE_%D0%9C%D0%9A%D0%91-10\" >Classification of the disease according to ICD-10<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/flu-in-pregnant-women-risks-for-mother-and-child-safe-treatment\/#%D0%98%D1%81%D1%82%D0%BE%D1%80%D0%B8%D1%8F_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D0%B8_%D0%B8%D0%BD%D1%82%D0%B5%D1%80%D0%B5%D1%81%D0%BD%D1%8B%D0%B5_%D0%B8%D1%81%D1%82%D0%BE%D1%80%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B5_%D1%84%D0%B0%D0%BA%D1%82%D1%8B\" >History of the disease and interesting historical facts<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/flu-in-pregnant-women-risks-for-mother-and-child-safe-treatment\/#%D0%AD%D0%BF%D0%B8%D0%B4%D0%B5%D0%BC%D0%B8%D0%BE%D0%BB%D0%BE%D0%B3%D0%B8%D1%8F_%D1%81%D1%82%D0%B0%D1%82%D0%B8%D1%81%D1%82%D0%B8%D0%BA%D0%B0_%D0%B2%D0%BE%D0%B7%D0%BD%D0%B8%D0%BA%D0%BD%D0%BE%D0%B2%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >Epidemiology: statistics on the occurrence of the disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/flu-in-pregnant-women-risks-for-mother-and-child-safe-treatment\/#%D0%93%D0%B5%D0%BD%D0%B5%D1%82%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B0%D1%8F_%D0%BF%D1%80%D0%B5%D0%B4%D1%80%D0%B0%D1%81%D0%BF%D0%BE%D0%BB%D0%BE%D0%B6%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D1%8C_%D0%BA_%D0%B3%D1%80%D0%B8%D0%BF%D0%BF%D1%83\" >Genetic predisposition to influenza<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/flu-in-pregnant-women-risks-for-mother-and-child-safe-treatment\/#%D0%A4%D0%B0%D0%BA%D1%82%D0%BE%D1%80%D1%8B_%D1%80%D0%B8%D1%81%D0%BA%D0%B0_%D0%B2%D0%BE%D0%B7%D0%BD%D0%B8%D0%BA%D0%BD%D0%BE%D0%B2%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B3%D1%80%D0%B8%D0%BF%D0%BF%D0%B0_%D1%83_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D1%8B%D1%85\" >Risk factors for influenza in pregnant women<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/flu-in-pregnant-women-risks-for-mother-and-child-safe-treatment\/#%D0%94%D0%B8%D0%B0%D0%B3%D0%BD%D0%BE%D1%81%D1%82%D0%B8%D0%BA%D0%B0_%D0%B3%D1%80%D0%B8%D0%BF%D0%BF%D0%B0_%D1%83_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D1%8B%D1%85\" >Diagnosis of influenza in pregnant women<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/flu-in-pregnant-women-risks-for-mother-and-child-safe-treatment\/#%D0%9B%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D0%B5_%D0%B3%D1%80%D0%B8%D0%BF%D0%BF%D0%B0_%D1%83_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D1%8B%D1%85\" >Treatment of influenza in pregnant women<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/flu-in-pregnant-women-risks-for-mother-and-child-safe-treatment\/#%D0%A1%D0%BF%D0%B8%D1%81%D0%BE%D0%BA_%D0%BB%D0%B5%D0%BA%D0%B0%D1%80%D1%81%D1%82%D0%B2_%D0%BF%D1%80%D0%B8%D0%BC%D0%B5%D0%BD%D1%8F%D0%B5%D0%BC%D1%8B%D1%85_%D0%BF%D1%80%D0%B8_%D0%B3%D1%80%D0%B8%D0%BF%D0%BF%D0%B5_%D1%83_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D1%8B%D1%85\" >List of medications used for influenza in pregnant women<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/flu-in-pregnant-women-risks-for-mother-and-child-safe-treatment\/#%D0%9C%D0%BE%D0%BD%D0%B8%D1%82%D0%BE%D1%80%D0%B8%D0%BD%D0%B3_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D0%BA%D0%BE%D0%BD%D1%82%D1%80%D0%BE%D0%BB%D1%8C%D0%BD%D1%8B%D0%B5_%D1%8D%D1%82%D0%B0%D0%BF%D1%8B_%D0%BF%D1%80%D0%BE%D0%B3%D0%BD%D0%BE%D0%B7_%D0%BE%D1%81%D0%BB%D0%BE%D0%B6%D0%BD%D0%B5%D0%BD%D0%B8%D1%8F\" >Disease monitoring: control stages, prognosis, complications<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/flu-in-pregnant-women-risks-for-mother-and-child-safe-treatment\/#%D0%92%D0%BE%D0%B7%D1%80%D0%B0%D1%81%D1%82%D0%BD%D1%8B%D0%B5_%D0%BE%D1%81%D0%BE%D0%B1%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8_%D1%82%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B3%D1%80%D0%B8%D0%BF%D0%BF%D0%B0_%D1%83_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D1%8B%D1%85\" >Age-related features of influenza in pregnant women<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-11\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/flu-in-pregnant-women-risks-for-mother-and-child-safe-treatment\/#%D0%92%D0%BE%D0%BF%D1%80%D0%BE%D1%81%D1%8B_%D0%B8_%D0%BE%D1%82%D0%B2%D0%B5%D1%82%D1%8B\" >Questions and Answers<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-12\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/flu-in-pregnant-women-risks-for-mother-and-child-safe-treatment\/#%D0%A2%D0%B8%D0%BF%D0%B8%D1%87%D0%BD%D1%8B%D0%B5_%D0%BE%D1%88%D0%B8%D0%B1%D0%BA%D0%B8_%D0%B8_%D0%BA%D0%B0%D0%BA_%D0%B8%D1%85_%D0%B8%D0%B7%D0%B1%D0%B5%D0%B6%D0%B0%D1%82%D1%8C\" >Typical mistakes and how to avoid them<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-13\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/flu-in-pregnant-women-risks-for-mother-and-child-safe-treatment\/#%D0%98%D1%82%D0%BE%D0%B3_%D1%87%D1%82%D0%BE_%D0%B2%D0%B0%D0%B6%D0%BD%D0%BE_%D0%B7%D0%BD%D0%B0%D1%82%D1%8C_%D0%BA%D0%B0%D0%B6%D0%B4%D0%BE%D0%B9_%D0%B1%D1%83%D0%B4%D1%83%D1%89%D0%B5%D0%B9_%D0%BC%D0%B0%D0%BC%D0%B5\" >Conclusion: what every future mother should know<\/a><\/li><\/ul><\/nav><\/div>\n<h2><span class=\"ez-toc-section\" id=\"%D0%9A%D0%BB%D0%B0%D1%81%D1%81%D0%B8%D1%84%D0%B8%D0%BA%D0%B0%D1%86%D0%B8%D1%8F_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D0%BF%D0%BE_%D0%9C%D0%9A%D0%91-10\"><\/span>Classification of the disease according to ICD-10<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>According to the International Classification of Diseases, 10th Revision (ICD-10), influenza falls under the category \"Viral infections of the respiratory tract\" and is coded as <strong>J09\u2013J11<\/strong>Specifically:<\/p>\n<ul>\n<li><strong>J09<\/strong> \u2014 influenza caused by identified influenza virus A (e.g., H1N1, H5N1);<\/li>\n<li><strong>J10<\/strong> \u2014 influenza caused by identified influenza virus B;<\/li>\n<li><strong>J11<\/strong> \u2014 influenza, virus not identified (\"unspecified\" influenza).<\/li>\n<\/ul>\n<p>For pregnant women, additional coding from the block <strong>O98\u2013O99<\/strong> \u2014 \"Infectious and parasitic diseases complicating pregnancy, childbirth, and the postpartum period.\" In particular, <strong>O98.5<\/strong> \u2014 \"Influenza complicating pregnancy.\" This code is critical for medical statistical reporting and affects the priority of care: with its presence, the patient automatically falls into the high-risk group and receives enhanced monitoring.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%98%D1%81%D1%82%D0%BE%D1%80%D0%B8%D1%8F_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D0%B8_%D0%B8%D0%BD%D1%82%D0%B5%D1%80%D0%B5%D1%81%D0%BD%D1%8B%D0%B5_%D0%B8%D1%81%D1%82%D0%BE%D1%80%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B5_%D1%84%D0%B0%D0%BA%D1%82%D1%8B\"><\/span>History of the disease and interesting historical facts<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Influenza has been known to humanity since ancient times. The first reliable description of an epidemic resembling influenza dates back to 412 BC, when Hippocrates described \"fever with cough and shortness of breath\" in Greece. But a real breakthrough in understanding the disease occurred only in the 20th century.<br \/>\nIn 1918, the \"Spanish flu\" broke out \u2014 a pandemic of influenza A(H1N1) that claimed the lives of 50 million people worldwide. The peculiarity of this wave was the high mortality among young adults, including pregnant women. Studies in the 2000s showed: among women in position, mortality reached 25\u201330%, while in the general population it was about 2%. The reason was a combination of immunosuppression, hyper-inflammatory response, and a sharp increase in blood volume, which overloaded the lungs and heart.<br \/>\nAnother curious fact: in 1957, during the \"Asian flu\" pandemic (A\/H2N2), doctors in the USA first used an antiviral drug \u2014 amantadine. It proved effective against the influenza A virus, but not B. Later, it was found that the virus mutates rapidly \u2014 by the end of the 1960s, most strains had become resistant to it. Today, amantadine is hardly used, while oseltamivir and zanamivir have come to replace it \u2014 drugs that block neuraminidase, an enzyme without which the virus cannot exit the cell.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%AD%D0%BF%D0%B8%D0%B4%D0%B5%D0%BC%D0%B8%D0%BE%D0%BB%D0%BE%D0%B3%D0%B8%D1%8F_%D1%81%D1%82%D0%B0%D1%82%D0%B8%D1%81%D1%82%D0%B8%D0%BA%D0%B0_%D0%B2%D0%BE%D0%B7%D0%BD%D0%B8%D0%BA%D0%BD%D0%BE%D0%B2%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>Epidemiology: statistics on the occurrence of the disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Every year, between 5 to 15% of the world's population gets infected with influenza \u2014 that\u2019s 290\u2013650 million people. According to WHO, seasonal outbreaks lead to 3\u20135 million cases of severe complications and 290\u2013650 thousand deaths annually. Pregnant women have a hospitalization risk 4\u201310 times higher than non-pregnant women of the same age.<br \/>\nIn Russia, between 20 to 40 million cases of ARVI and influenza are registered annually. According to Rospotrebnadzor for 2023\u20132024, among those hospitalized with influenza, 12\u201318% were pregnant women. Of these cases, 60\u201370% occurred in the third trimester. Interestingly, during the COVID-19 pandemic, the incidence of influenza sharply declined \u2014 due to mask mandates, quarantines, and social distancing. However, since 2022, the return of the \"usual\" flu season has become particularly aggressive: in the 2023\/24 season, the A(H1N1)pdm09 strain dominated, which is especially dangerous for young people and pregnant women.<br \/>\nIt is important to understand: influenza is not just a winter phenomenon. In countries with a tropical climate, it circulates year-round, while in temperate latitudes \u2014 from October to May, peaking in January\u2013February. For pregnant women, the risk of infection increases not only due to the season but also due to visits to clinics where many infected individuals are present.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%93%D0%B5%D0%BD%D0%B5%D1%82%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B0%D1%8F_%D0%BF%D1%80%D0%B5%D0%B4%D1%80%D0%B0%D1%81%D0%BF%D0%BE%D0%BB%D0%BE%D0%B6%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D1%8C_%D0%BA_%D0%B3%D1%80%D0%B8%D0%BF%D0%BF%D1%83\"><\/span>Genetic predisposition to influenza<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>There is no direct \"flu gene\" \u2014 the incidence is determined not by genetics in pure form, but by a combination of genetic variants that affect the immune response. Studies show that certain polymorphisms in genes encoding receptors for interferons (for example, <strong>IFITM3<\/strong>) increase susceptibility to severe influenza.<br \/>\nThe gene <strong>IFITM3<\/strong> is responsible for synthesizing a protein that blocks the virus from entering the cell. In carriers of the rs12252-C variant, the risk of developing pneumonia with influenza increases sixfold. Another gene \u2014 <strong>TLR7<\/strong>, involved in recognizing RNA viruses. Mutations here are more common in men and are associated with severe disease, but the role of TLR7 in pregnant women is still not fully understood.<br \/>\nIt is also important: women with certain HLA alleles (for example, HLA-DRB1*15:01) exhibit a weaker T-cell response to the influenza virus. This does not mean they are \"doomed\" to get sick \u2014 it simply means their immune system may respond more slowly. Therefore, prevention and early treatment are critical for them.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%A4%D0%B0%D0%BA%D1%82%D0%BE%D1%80%D1%8B_%D1%80%D0%B8%D1%81%D0%BA%D0%B0_%D0%B2%D0%BE%D0%B7%D0%BD%D0%B8%D0%BA%D0%BD%D0%BE%D0%B2%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B3%D1%80%D0%B8%D0%BF%D0%BF%D0%B0_%D1%83_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D1%8B%D1%85\"><\/span>Risk factors for influenza in pregnant women<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Risk factors can be divided into three groups: biological, behavioral, environmental.<br \/>\n<strong>Biological:<\/strong><\/p>\n<ul>\n<li>Decreased cellular immunity (reduced activity of T-lymphocytes and NK cells);<\/li>\n<li>Physiological increase in the volume of circulating blood (+40\u201350 %), which increases the load on the lungs;<\/li>\n<li>Diaphragm displacement upwards due to the growth of the uterus \u2014 reduction of lung vital capacity %;<\/li>\n<li>Hormonal changes: progesterone suppresses the inflammatory response, estrogens enhance the expression of virus receptors in the respiratory epithelium.<\/li>\n<\/ul>\n<p><strong>Behavioral:<\/strong><\/p>\n<ul>\n<li>Refusal of vaccination (often due to myths about \"harm to the fetus\");<\/li>\n<li>Frequent trips on public transport, visiting clinics without a mask;<\/li>\n<li>Lack of sleep and chronic stress \u2014 reduce interferon production.<\/li>\n<\/ul>\n<p><strong>Environmental:<\/strong><\/p><script data-noptimize=\"\" data-wpfc-render=\"false\">\nfpm_start( \"true\" );\n<\/script>\n\n<ul>\n<li>Living in an apartment building with a large number of neighbors;<\/li>\n<li>Working in educational or medical institutions;<\/li>\n<li>Seasonal circulation of the virus (especially when coinciding with the epidemic threshold).<\/li>\n<\/ul>\n<p>Note: even if you do not leave the house, there is a risk \u2014 through your husband, children, couriers. The virus remains on surfaces for up to 48 hours, and in the air \u2014 up to 1 hour under normal humidity.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%94%D0%B8%D0%B0%D0%B3%D0%BD%D0%BE%D1%81%D1%82%D0%B8%D0%BA%D0%B0_%D0%B3%D1%80%D0%B8%D0%BF%D0%BF%D0%B0_%D1%83_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D1%8B%D1%85\"><\/span>Diagnosis of influenza in pregnant women<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>The diagnosis is made based on the clinical picture and laboratory confirmation. In pregnant women, symptoms may be \"masked\" \u2014 for example, fever below 38 \u00b0C, but with pronounced weakness and shortness of breath. This is called \"atypical course\" and often leads to delayed diagnosis.<br \/>\n<strong>Main symptoms:<\/strong><\/p>\n<ul>\n<li>Acute onset (within 1\u20132 hours): headache, body aches, chills;<\/li>\n<li>Temperature \u226538 \u00b0C (may be subfebrile \u2014 37.5\u201338.0 \u00b0C in some);<\/li>\n<li>Dry cough, sore throat, nasal congestion (more often secondary);<\/li>\n<li>Shortness of breath with physical exertion \u2014 a worrying signal, especially in the third trimester;<\/li>\n<li>Increased heart rate (&gt;100 beats\/min) \u2014 may indicate the early stage of pneumonia.<\/li>\n<\/ul>\n<p><strong>Laboratory tests:<\/strong><\/p>\n<table border=\"1\" cellpadding=\"5\" cellspacing=\"0\" style=\"width:100%;border-collapse:collapse\">\n<tr>\n<th>Method<\/th>\n<th>Time to obtain results<\/th>\n<th>Accuracy<\/th>\n<th>Features during pregnancy<\/th>\n<\/tr>\n<tr>\n<td>Rapid antigen test (nasal swab)<\/td>\n<td>15\u201330 min<\/td>\n<td>50\u201370 % (low sensitivity)<\/td>\n<td>Can be done at the clinic; if negative, but symptoms are pronounced \u2014 PCR is needed<\/td>\n<\/tr>\n<tr>\n<td>PCR (swab from the nasopharynx and oropharynx)<\/td>\n<td>2\u20136 hours<\/td>\n<td>95\u201399%<\/td>\n<td>Gold standard; conducted in licensed laboratories<\/td>\n<\/tr>\n<tr>\n<td>ELISA for antibodies (IgM\/IgG)<\/td>\n<td>1\u20132 days<\/td>\n<td>70\u201385 %<\/td>\n<td>IgM \u2014 acute infection; IgG \u2014 past infection or vaccination<\/td>\n<\/tr>\n<\/table>\n<p><strong>Radiological examinations:<\/strong><br \/>\nChest X-ray when pneumonia is suspected is done with abdominal protection (lead shield). Modern machines give a dose of 0.01\u20130.03 mSv \u2014 this is safe for the fetus (the risk threshold starts at 100 mSv). CT \u2014 only for vital indications, with a minimal dose.<br \/>\n<strong>Differential diagnosis:<\/strong><br \/>\nIt is necessary to distinguish influenza from:<\/p>\n<ul>\n<li>ARVI (usually without fever above 38.5 \u00b0C, severe chills and aches);<\/li>\n<li>COVID-19 (often with anosmia, diarrhea, longer cough);<\/li>\n<li>Bacterial pneumonia (temperature lasts &gt;5 days, purulent sputum);<\/li>\n<li>Toxicosis of the second half of pregnancy (preeclampsia) \u2014 there is no cough, but there are edema, proteinuria, and BP &gt;140\/90.<\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"%D0%9B%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D0%B5_%D0%B3%D1%80%D0%B8%D0%BF%D0%BF%D0%B0_%D1%83_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D1%8B%D1%85\"><\/span>Treatment of influenza in pregnant women<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Treatment should begin **within the first 48 hours** after the onset of symptoms. The earlier, the higher the chance of avoiding complications. The main rule: no self-medication. No \"hot tea with honey,\" no \"paracetamol at 3 tablets\" \u2014 only as prescribed by a doctor.<br \/>\n<strong>General treatment:<\/strong><\/p>\n<ul>\n<li><strong>Bed rest<\/strong> \u2014 even with a mild course. In a side position (preferably on the left), blood flow to the placenta improves;<\/li>\n<li><strong>Abundant drinking<\/strong> \u2014 at least 2 liters\/day: water, dried fruit compote, herbal teas (chamomile, mint \u2014 without St. John's wort and thyme);<\/li>\n<li><strong>Humidification of the air<\/strong> \u2014 50\u201360 % humidity reduces viral load in the room;<\/li>\n<li><strong>Temperature control<\/strong> \u2014 at \u226538.5 \u00b0C, fever should be reduced (see below).<\/li>\n<\/ul>\n<p><strong>Pharmacological treatment:<\/strong><br \/>\nThe basis is antiviral drugs based on **oseltamivir** (Tamiflu\u00ae). It is prescribed at a dose of 75 mg twice a day for 5 days. Effectiveness is confirmed by WHO and the Ministry of Health of the Russian Federation: when used in a timely manner, it reduces the risk of hospitalization by 60 % and shortens the duration of fever by 1\u20132 days.<br \/>\nImportant: oseltamivir is allowed from the first trimester. In 2011, a study on 5500 pregnant women was published in Lancet \u2014 no side effects were found in the mother or fetus. Zanamivir (Relenza\u00ae) \u2014 inhalational, less studied in pregnant women, therefore used only in case of intolerance to oseltamivir.<br \/>\n<strong>Fever reduction:<\/strong><br \/>\nParacetamol is the only approved antipyretic. Dose \u2014 500 mg every 6 hours (max. 4 g\/day). Ibuprofen, aspirin, and analgin cannot be used \u2014 they increase the risk of bleeding and fetal development disorders.<br \/>\n<strong>Surgical treatment:<\/strong><br \/>\nIt is not used for influenza as such. But in case of complications \u2014 for example, lung abscess or pleural empyema \u2014 drainage may be required. In such cases, the decision is made by a multidisciplinary team: obstetrician-gynecologist, pulmonologist, anesthesiologist.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%A1%D0%BF%D0%B8%D1%81%D0%BE%D0%BA_%D0%BB%D0%B5%D0%BA%D0%B0%D1%80%D1%81%D1%82%D0%B2_%D0%BF%D1%80%D0%B8%D0%BC%D0%B5%D0%BD%D1%8F%D0%B5%D0%BC%D1%8B%D1%85_%D0%BF%D1%80%D0%B8_%D0%B3%D1%80%D0%B8%D0%BF%D0%BF%D0%B5_%D1%83_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D1%8B%D1%85\"><\/span>List of medications used for influenza in pregnant women<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Here is a verified list of medications approved and recommended by the Ministry of Health of the Russian Federation and WHO for use during pregnancy:<\/p>\n<table border=\"1\" cellpadding=\"5\" cellspacing=\"0\" style=\"width:100%;border-collapse:collapse\">\n<tr>\n<th>Preparation<\/th>\n<th>Active ingredient<\/th>\n<th>Duration of use<\/th>\n<th>Features<\/th>\n<\/tr>\n<tr>\n<td>Tamiflu\u00ae<\/td>\n<td>Oseltamivir<\/td>\n<td>Any trimester<\/td>\n<td>First line. Take within 48 hours after symptoms.<\/td>\n<\/tr>\n<tr>\n<td>Paracetamol<\/td>\n<td>Paracetamol<\/td>\n<td>Any trimester<\/td>\n<td>Max. 4 g\/day. Do not mix with other products containing paracetamol.<\/td>\n<\/tr>\n<tr>\n<td>Aqualor\u00ae Forte<\/td>\n<td>Isotonic solution of seawater + aloe extract<\/td>\n<td>Any trimester<\/td>\n<td>Nasal irrigation - reduces viral load, moisturizes the mucosa.<\/td>\n<\/tr>\n<tr>\n<td>Lizobact\u00ae<\/td>\n<td>Lysozyme + pyridoxine<\/td>\n<td>II\u2013III trimester<\/td>\n<td>For local use in case of angina\/pharyngitis. Safe, but does not replace antiviral drugs.<\/td>\n<\/tr>\n<tr>\n<td>Viferon\u00ae suppositories<\/td>\n<td>Interferon alpha-2b + vitamins E and C<\/td>\n<td>II\u2013III trimester<\/td>\n<td>Immunomodulator. Effectiveness is disputed, but it is allowed. Does not replace oseltamivir.<\/td>\n<\/tr>\n<\/table>\n<p><strong>Prohibited drugs:<\/strong><\/p>\n<ul>\n<li>Aspirin \u2014 risk of Reye's syndrome in children and bleeding;<\/li>\n<li>Ibuprofen and other NSAIDs \u2014 especially in the III trimester (risk of premature closure of the ductus arteriosus);<\/li>\n<li>Amantadine and rimantadine \u2014 outdated, virus resistance &gt;99 %;<\/li>\n<li>Antibiotics without indications do not treat viruses, but disrupt the microflora and increase the risk of fungal infections.<\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"%D0%9C%D0%BE%D0%BD%D0%B8%D1%82%D0%BE%D1%80%D0%B8%D0%BD%D0%B3_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D0%BA%D0%BE%D0%BD%D1%82%D1%80%D0%BE%D0%BB%D1%8C%D0%BD%D1%8B%D0%B5_%D1%8D%D1%82%D0%B0%D0%BF%D1%8B_%D0%BF%D1%80%D0%BE%D0%B3%D0%BD%D0%BE%D0%B7_%D0%BE%D1%81%D0%BB%D0%BE%D0%B6%D0%BD%D0%B5%D0%BD%D0%B8%D1%8F\"><\/span>Disease monitoring: control stages, prognosis, complications<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>After diagnosis and the start of treatment, regular monitoring is necessary. Here are the key steps:<br \/>\n<strong>Day 1\u20132:<\/strong><br \/>\n\u2014 Temperature control every 4 hours;<br \/>\n\u2014 Assessment of respiratory function: respiratory rate &gt;20 per minute is a warning sign;<br \/>\n\u2014 Ultrasound of the fetus (if there are complaints of decreased movements).<br \/>\n<strong>Day 3\u20134:<\/strong><br \/>\n\u2014 If the temperature does not decrease, a repeat PCR and X-ray are needed;<br \/>\n\u2014 Blood test: leukocytes, C-reactive protein, platelets (risks of DIC syndrome);<br \/>\n\u2014 Blood pressure monitoring \u2014 hypertension may indicate preeclampsia against the background of infection.<br \/>\n<strong>Day 5\u20137:<\/strong><br \/>\n\u2014 If improvement occurs \u2014 continue therapy until the end of the course;<br \/>\n\u2014 If deterioration occurs \u2014 hospitalization in an infectious or obstetric department.<br \/>\n<strong>Forecast:<\/strong><br \/>\nWith timely treatment, 90-95% of pregnant women with influenza recover without consequences. But without therapy, the risk of complications increases:<\/p>\n<ul>\n<li>Pneumonia occurs in 5-10% of pregnant women with influenza;<\/li>\n<li>Premature birth occurs in 15-20% in cases of severe illness;<\/li>\n<li>Intrauterine growth retardation occurs with fever &gt;39 \u00b0C for more than 24 hours;<\/li>\n<li>Neonatal infection occurs if the mother fell ill 1-2 days before delivery (transmission during childbirth).<\/li>\n<\/ul>\n<p>Fetal hypoxia is particularly dangerous: fever reduces blood oxygen saturation, and the growing uterus compresses the inferior vena cava \u2014 this leads to a temporary decrease in blood flow through the placenta. That is why shortness of breath in a pregnant woman is not \"fatigue,\" but a signal to take action.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%92%D0%BE%D0%B7%D1%80%D0%B0%D1%81%D1%82%D0%BD%D1%8B%D0%B5_%D0%BE%D1%81%D0%BE%D0%B1%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8_%D1%82%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B3%D1%80%D0%B8%D0%BF%D0%BF%D0%B0_%D1%83_%D0%B1%D0%B5%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D1%8B%D1%85\"><\/span>Age-related features of influenza in pregnant women<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Influenza in pregnant women is not the same at 20 and 35 years old. Age affects the immune system's response and accompanying conditions.<br \/>\n<strong>Young pregnant women (under 25 years):**<br \/>\nThey often experience influenza more easily, but the risk of \"hyper-inflammatory storm\" is higher \u2014 when the immune system attacks not only the virus but also its own tissues. This can lead to acute respiratory distress syndrome (ARDS) even without pneumonia. They more frequently encounter the H1N1 strain \u2014 it aggressively affects the lungs of young individuals.<br \/>\n<\/strong><strong>Middle age (26-35 years):**<br \/>\nThe largest group of pregnant women. Here, the key factor is the presence of chronic diseases: bronchial asthma, diabetes, obesity. For example, with a BMI &gt;30, the risk of hospitalization increases by 3 times. Vaccination status is also important: if a woman received the vaccine last year, the illness will be milder.<br \/>\n<\/strong><strong>Older age (36+ years):**<br \/>\nThe risk of complications increases not because of the flu itself, but due to age-related changes: decreased lung function, arterial hypertension, metabolic disorders. These women are more likely to develop bacterial superinfection \u2014 for example, pneumococcal pneumonia. There is also an increased risk of thrombosis, especially if there is varicose veins or a predisposition to DIC.<br \/>\nAn interesting point: the risk is higher in primiparous women than in multiparous women. Probably because the body is adapting to the immunosuppressive state for the \"first time,\" and the protective mechanisms are not yet established.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%92%D0%BE%D0%BF%D1%80%D0%BE%D1%81%D1%8B_%D0%B8_%D0%BE%D1%82%D0%B2%D0%B5%D1%82%D1%8B\"><\/span>Questions and Answers<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><\/strong><strong>Can a flu vaccine be given during pregnancy?<\/strong><br \/>\nYes, and it is strongly recommended. Vaccination is carried out from the first trimester (from 12 weeks \u2014 optimally), but during an epidemic threshold \u2014 even earlier. Only inactivated vaccines are used (for example, \"Grippol Plus,\" \"Influvac\"). They do not contain live virus, so they cannot cause the flu. According to WHO data, vaccination reduces the risk of illness by 50% and severe complications by 70%. In newborns, passive immunity is formed through the placenta and breast milk in the first 6 months.<br \/>\n<strong>What to do if the temperature does not decrease after paracetamol?<\/strong><br \/>\nDo not increase the dose! More than 4 g\/day \u2014 risk of toxic liver damage. Do the following:<\/p>\n<ul>\n<li>Wipe the forehead, wrists, and armpits with cool water (not alcohol!);<\/li>\n<li>Place a cold compress on the forehead;<\/li>\n<li>Call a doctor \u2014 intravenous therapy or hospitalization may be needed;<\/li>\n<li>If the temperature is \u226539.5 \u00b0C for more than 6 hours \u2014 this is an indication for urgent hospitalization.<\/li>\n<\/ul>\n<p><strong>Can the flu cause a miscarriage?<\/strong><br \/>\nThere is no direct link \"flu \u2192 miscarriage,\" but there is an indirect one. High fever (\u226539 \u00b0C for more than 24 hours), severe intoxication, and hypoxia can provoke uterine contractions and disrupt placental blood flow. The first trimester is especially dangerous \u2014 when the organs of the fetus are being formed. Therefore, in the first 12 weeks, if there is any suspicion of the flu \u2014 contact a doctor immediately.<br \/>\n<strong>Is it safe to breastfeed with the flu?<\/strong><br \/>\nYes, and it is even recommended. The virus is not transmitted through milk. On the contrary, the antibodies produced by the mother enter the milk and protect the child. But while breastfeeding, wear a mask, wash your hands, and avoid coughing near the baby. If you are in a hospital \u2014 you can pump milk and give it through a bottle.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%A2%D0%B8%D0%BF%D0%B8%D1%87%D0%BD%D1%8B%D0%B5_%D0%BE%D1%88%D0%B8%D0%B1%D0%BA%D0%B8_%D0%B8_%D0%BA%D0%B0%D0%BA_%D0%B8%D1%85_%D0%B8%D0%B7%D0%B1%D0%B5%D0%B6%D0%B0%D1%82%D1%8C\"><\/span>Typical mistakes and how to avoid them<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><strong>Mistake 1: \"I'll wait a couple of days \u2014 it will pass on its own\"**<br \/>\nThe flu in pregnant women does not \"just pass.\" Within 48 hours, the virus has already invaded the cells, and every hour of delay increases the risk of pneumonia.<br \/>\n<\/strong><strong>How to avoid:<\/strong> At the first symptoms \u2014 call a doctor, PCR test, if confirmed \u2014 oseltamivir on the same day.<br \/>\n<strong>Mistake 2: \"I'll take ibuprofen \u2014 it's stronger than paracetamol\"**<br \/>\nIbuprofen in the third trimester blocks the synthesis of prostaglandins necessary for cervical dilation and water breaking. This can lead to delayed labor and hypoxia.<br \/>\n<\/strong><strong>How to avoid:<\/strong> Remember: only paracetamol. Keep it in the first box of your medicine cabinet.<br \/>\n<strong>Error 3: \"Vaccination is for others, I'm healthy anyway\"**<br \/>\nEven if you are not sick, the virus can reach you through your child or husband. And vaccination is not only your protection but also the protection of your future child.<br \/>\n<\/strong><strong>How to avoid:<\/strong> Sign up for a vaccination at the clinic in advance \u2014 during the season it ends by November.<br \/>\n<strong>Error 4: \"I will rinse my nose with soda and everything will pass\"**<br \/>\nSoda irritates the mucous membrane, causes dryness and microcracks \u2014 this facilitates the penetration of the virus.<br \/>\n<\/strong><strong>How to avoid: use only isotonic sea water solution (Aqualor, Physiomer) or saline solution.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%98%D1%82%D0%BE%D0%B3_%D1%87%D1%82%D0%BE_%D0%B2%D0%B0%D0%B6%D0%BD%D0%BE_%D0%B7%D0%BD%D0%B0%D1%82%D1%8C_%D0%BA%D0%B0%D0%B6%D0%B4%D0%BE%D0%B9_%D0%B1%D1%83%D0%B4%D1%83%D1%89%D0%B5%D0%B9_%D0%BC%D0%B0%D0%BC%D0%B5\"><\/span>Conclusion: what every future mother should know<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Influenza in pregnant women is not a reason to panic, but a reason to act clearly and quickly. The most important thing: <\/p>\n<ul>\n<li><strong>Prevention is the best treatment.<\/strong> Vaccination on time reduces the risk significantly;<\/li>\n<li><strong>The first 48 hours is a critical window.<\/strong> Oseltamivir should be started by the 2nd day of illness;<\/li>\n<li><strong>Temperature \u226538.5 \u00b0C \u2014 do not ignore.<\/strong> Paracetamol is your ally;<\/li>\n<li><strong>Shortness of breath is not \"normal.\"<\/strong> This is a signal for urgent examination;<\/li>\n<li><strong>Do not hesitate to reach out.<\/strong> Doctors know how to treat influenza in pregnant women \u2014 and do it every day.<\/li>\n<\/ul>\n<p>Remember: you are not alone. Over the past 10 years, clear protocols for managing pregnant women with influenza have been developed in Russia. And if you follow the recommendations \u2014 the chances of a healthy child and a quick recovery are very high. Your task is not to \"survive,\" but to **start treatment on time**. And we are here to help you do it right.<\/strong><\/p>\n<div class=\"fpm_end\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Influenza in pregnant women is not just a \"cold with a fever,\" but a serious viral disease that can cause complications for both the future<\/p>","protected":false},"author":1,"featured_media":24191,"comment_status":"open","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[298],"tags":[],"class_list":["post-17682","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medlibrary"],"_links":{"self":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts\/17682","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/comments?post=17682"}],"version-history":[{"count":2,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts\/17682\/revisions"}],"predecessor-version":[{"id":19636,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts\/17682\/revisions\/19636"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/media\/24191"}],"wp:attachment":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/media?parent=17682"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/categories?post=17682"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/tags?post=17682"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}