SARS prognosis in gravidas guarded: two of seven patients died.

HYANNIS, MASS.--The clinical presentation of severe acute respiratory syndrome in pregnant women is similar to that seen in nongravid patients, but the prognosis may be more guarded.

That finding emerged from a case series of seven pregnant women admitted earlier this year to a Hong Kong hospital with a diagnosis of probable severe acute respiratory syndrome (SARS).

"The data presented here are the first to describe SARS in a group of pregnant women," Dr. Bernard Gonik said at the annual meeting of the Infectious Diseases Society for Obstetrics and Gynecology.

"Our initial observations suggest the disease presents similarly in pregnant women, but [this population may be at greater risk for complications and more severe disease progression," said Dr. Gonik, who presented the data on behalf of lead investigator Dr. S. F. Wong of Princess Margaret Hospital, where the seven women were treated.

Four of the seven patients required ICU admission for ventilation assistance (three of the four required mechanical ventilation) and two patients died. In non-pregnant SAPS patients, the ICU admission rate and the mortality rate have been reported as 20% and 10%, respectively said Dr. Gonik of Wayne State University, Detroit.

No direct neonatal effect from the virus or treatment was observed, although neonatal condition was associated with the disease state of the mother. The infected women ranged in age from 22 to 34 years, and gestational age at admission ranged from 6 to 31 weeks.

SARS was presumptively diagnosed based on epidemiologic linkage and symptoms. Upon presentation, the women had fever, chills, rigors, myalgias, and malaise. Cough was noted in five patients, headache in four, and shortness of breath in three.