Swine flu fatal in pregnancy

Four maternal deaths are among New Zealand's 18 official swine flu deaths - but three of the babies involved survived.

Two of the women who died came from the wider Auckland area, one was from the Waikato and another was from the Wellington region.

All are believed to have contracted swine flu in the third trimester of their pregnancies.

It is understood the baby who died was from the Wellington area.

"All of the babies are doing well - apart from one," said Dr Claire McLintock, the lead clinician of obstetric medicine at National Women's and chair of the Maternal Mortality Working Group.

She said maternal deaths included any women who died while pregnant or up to six weeks after they had their baby.

She could not reveal the particulars about the cases, including at what stage the babies were delivered and how long after the deliveries the women died.

Dr Colin McArthur, clinical director of the department of critical care medicine at Auckland City Hospital, said the Australasian Maternal Outcomes Surveillance System group (which looks at pregnancy complications here and over the Tasman) and the Australia and New Zealand Intensive Care Society were investigating the deaths.

The reviews would also look into the 66 Kiwi and Australian pregnant mothers who were admitted to intensive care units with swine flu between June 1 and August 31 this year - the heightened period of the swine flu pandemic.

The pregnant women affected were among the 722 New Zealand and Australian patients with swine flu who were tracked during these three months and who were admitted to intensive care services.

McArthur hoped the results of the two investigations would help health professionals better understand the at-risk group as they prepared for the next wave of swine flu. This could come at any time but is most likely next winter.

He said pregnant women were seven times more likely than other women of the same age to end up in intensive care if they contracted swine flu.

McLintock said obstetric physicians at National Women's at Auckland City Hospital were also looking at the cases of about 40 pregnant women who had suffered from swine flu during the same three months, whether or not they had been admitted to intensive care units.

The women were from Auckland, North Shore and Middlemore hospitals.

She said most of the pregnant women were admitted into care in the third trimester, when the baby was large and "squashes up" on the mother's lungs, affecting her breathing and trapping fluid.

This explained why pregnant women were at greater risk of an infection, she said. As well, women's immunity was compromised while they were pregnant.

McLintock said the women, aged in their 20s and 30s, were treated with Tamiflu.

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