When we met it never occurred to me that she was going to die. But I can still hear the sound of her ribs crack with each chest compression. Sometimes I get a flash image of her unattended arm sliding off the bed alongside a swath of brown hair. Mary was dead. It was clear to everyone, though it took sometime before we could summon the courage to admit it. This pregnant woman, mother of a two-year girl with blonde hair, died from the flu.
Only Fifty three percent of pregnant women are vaccinated against the flu.
It’s really hard to convince pregnant women to take medicine, especially if it’s in the form of a vaccine. It’s medicine for an illness they don’t have. Even the tiniest, most theoretical, risk is thought too much. The unvaccinated, however, represent a lost opportunity for mothers to protect themselves and their babies, who cannot get vaccinated for the first six months of life.
This is one of the worst Influenza flu seasons on record. Thus far in the 2019-2020 flu season, 55000 people have gotten the flu and 2900 have died. Pregnant women are at greater risk of getting the flu because pregnancy itself hampers the immune’s system ability to ward off the infection. Pregnant women are more likely to get pneumonia when they have the flu. When pregnant women do become ill with the flu, they are more likely to need hospitalization, and more likely to need intubation and care in the Intensive Care Unit.
And, because the flu is an infection that causes a high fever, there is also an increased risk of going into labor prematurely.
On the morning Mary died she woke up and felt dizzy, and had an annoying cough.
Her husband brought her to the hospital because she had fainted. A half an hour after she arrived to the emergency room her heart began to beat irregularly. She was rushed to the cardiac catheterization laboratory, and while they were evaluating her irregular rhythm, her heart stopped beating. A code was called. The cardiologists and the critical care doctors began chest compressions. Obstetricians (me included) went about starting an emergency caesarean section to deliver her thirty-two week old fetus—while her body was bouncing up and down on the table. Mary started to bleed profusely because of a reaction called DIC (disseminated intravascular coagulation). More doctors filled the little procedure room. More blood filled the abdomen.
We extended her incision from the pubic hairline to the breastbone in order to better see and control the bleeding. Her bowels fell out of her body and rested on the white sheets; they changed color from pink to a dusky brown. More blood. The cardiac doctors were compressing her chest, still trying to revive her heart. Ribs cracked. Her head lobbed to the side, and her brown hair cascaded off the bed in slow resignation.
That’s when I could feel it; she was gone. In our fear and anguish we feverishly tried to pound and stich life back into Mary. No one could accept the sudden loss of this young mother–from the flu. I was so relieved when the code leader said it: stop. This woman was alive two hours before, and now this family, these two girls, will have to forge ahead without her. She declined her influenza vaccine and the virus infected her heart—a rare and ridiculous reason to die. I’m still angry.
And if you have symptoms, get treated. The Center for Disease Control and the American College of Obstetricians and Gynecologist state that pregnant women can be safely treated for flu symptoms with Tamiflu (Oseltamivir) or Relenza (Zanamir).