Age: 33.0
Sex: F
Vaccine: FLUN(H1N1), FLUN(H1N1)
Symptoms: Nasal discomfort, Nausea, Pre-eclampsia, Pregnancy, Retained placenta or membranes
Clinical narrative: A serious spontaneous report of administration of H1N1 to a pregnant female, atypical preeclampsia and gestational diabetes with signs of impaired glucose tolerance and non-serious events of retained placenta, occasional dizziness, nasal discomfort with a sign of nasal itchiness, nausea, early morning nausea, headache, increased fatigue with signs of feeling tired or poorly, increased sneezing and rhinorrhea with a sign of nasal discharge has been received from a healthcare professional concerning a 34-year-old female, subsequent to H1N1 Vaccine, Intranasal. The patient had a past medical history of seasonal allergies, abortion and depression. The patient's obstetrical history included gravida four para three and the abortion was elective, not spontaneous. LMP of the patient was 09-Sep-2009 and EDD was 15-Jun-2010. At the time of receiving the vaccine, the patient was three weeks pregnant. No concomitant medications were reported. The patient received H1N1 Vaccine, Intranasal on 20-Oct-2009, nasally for an unknown indication. On 23-Oct-2009, the patient experienced nausea, headache, increased fatigue, feeling tired or poorly and occasional dizziness, nasal itchiness, increased sneezing and nasal discharge and the physical findings were, temperature: 99.2 F, weight: 142 lbs, general appearance: well-developed and well nourished in no acute distress, lungs clear to auscultation, heart sound normal, no murmurs were heard, abdominal auscultation revealed no abnormalities, on palpation abdomen was soft, no tenderness, no mass palpated, abdominal muscle guarding was not demonstrated. The patient was seen again in Jan-2010 by the physician and at that visit, the patient complained that she had begun to experience some early morning nausea, but the physician reported that at this stage of the pregnancy the nausea was related to her pregnancy and not the vaccine. During the pregnancy the patient experienced atypical preeclampsia and gestational diabetes. The patient was induced at 36 weeks gestation and received magnesium sulfate intrapartum  to treat the preeclampsia. On 19-May-2010, the patient delivered by NVSD (normal vaginal spontaneous delivery), a female infant weighing 5 lbs and 13 ozs. Apgars were 9 at 1 min and 9 at 5 mins. After the birth she had a dilatation & curettage for retained placenta. The patient was seen on 08-Jul-2010 in a postpartum visit and everything was fine. Since the delivery she now has impaired glucose tolerance, she is seen and treated with diet modification. The outcome of vaccine exposure during pregnancy was recovered on 20-Oct-2009, retained placenta was recovered on 19-May-2010, occasional dizziness, nasal discomfort with a sign of nasal itchiness, headache, increased fatigue, increased sneezing and rhinorrhea with a sign of nasal discharge was recovered on 11-Nov-2009. The outcome of the events of nausea, early morning nausea and atypical preeclampsia were unknown. The outcome of gestational diabetes was not recovered. Additional information was received on 24-Nov-2009 and incorporated into the narrative: narrative changed to eight paragraph, event terms added, medical and obstetrical history, physical findings of the patient. Additional information was received on 07-Jan-2010 and incorporated into the narrative: Obstetrical history of the patient (Gravida and para). Additional information was received 15-Jan-2010 and incorporated into the narrative: event early morning nausea added, obstetrical history and outcome of the event. Other additional information included details of reporter and route of administration. Additional information was received on 02-Aug-2010 and incorporated into the narrative: Additional events, patient medical history and pregnancy outcome. Other additional information received was the reporter information. The case was upgraded to be a serious case. As discussed with the physician, the events of 'administration of H1N1 to a three weeks pregnant female', 'atypical preeclampsia' and 'gestational diabetes' with signs of impaired glucose tolerance were considered to be 'Important Medical Events'. And the event of 'retained placenta' was considered to be a non-serious event.