The most common complication of A H1N1 influenza is pneumonia. The plan of management in such cases has been summarized in Table 5 . Complications must be recognized and treated appropriately. In order to treat pneumonia effectively, the antimicrobial therapy should be based on bacteriological sensitivities. However, pending bacteriological confirmation, co-amoxiclav (Augmentin) is the recommended empiric antibiotic. In penicillin sensitive patients, Clarithromycin is a suggested alternative. Co-amoxiclav is not contraindicated in pregnancy. In situations where there is preterm prelabour rupture of membranes concomitant with pneumonia, the use of co-amoxiclav is not recommended because of the increased risk of necrotizing enterocolitis observed in the ORACLE study. An alternative antibiotic such as piperacillin is recommended and the microbiologist should be involved in management discussions. In addition, antiviral treatment should be started on clinical grounds whilst awaiting test results. It is also important to treat maternal pyrexia with paracetamol and not Non Steroidal Anti Inflammatory Drugs (NSAID). Epidemiological studies have linked uncontrolled maternal pyrexia to miscarriage and fetal abnormalities such as neural tube and cardiac defects. Maternal pyrexia is also a recognised risk factor for preterm delivery. The importance of control of maternal pyrexia with regular and effective doses of paracetamol and hydration should be emphasised.