Evidence on the useful role of NIV in pregnant patients with ARDS secondary H1N1 viral infection was lacking. Dr. Amit Banga [30] reported a 28-year-old pregnant female with ARDS (PaO 2 /FiO 2 155) due to community-acquired severe pneumonia who successfully treated with NIV. In 2009, Dr. Michel Djibre and collegues [31] reported a 38-year-old pregnant woman at 31 weeks' gestation with PaO 2 /FiO 2 98 who was successfully treated with NIV. In our study, the success rate among pregnant women with H1N1 infection for NIV was 45.8%. A recent prospective multicenter survey also found that when NIV was used as first-line therapy for selected ALI/ARDS patients (those with 2 organ failures, hemodynamic instability, or encephalopathy were excluded), 54% avoided intubation and had excellent outcomes [32] .