Acute H 1 N 1 infections in pregnancy have been reported in the current pandemic leading to severe morbidity, as seen in our two patients, and mortality [14, 15] . The fact that this influenza A (H 1 N 1 ) can develop in healthy patients and evolve in few hours to a severe ARDS with a refractory hypoxemia needing recourse to ECMO in 5% to 20% of patients is novel [16, 17] . The first publications of patients admitted to intensive care units for severe influenza A (H 1 N 1 ) often associated to an ARDS reported a mortality rate from 15% to 40% [18] .