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Beating Odds: When H1N1 struck during pregnancy, lives hung in balance

SACRAMENTO — Jessica Cruz has beaten the worst of the new H1N1 flu statistics.

Three months after paramedics rolled her into a hospital with respiratory failure, she and her fiancé of nine years are to be married today.

And they have a healthy 6-pound 6-ounce baby boy.

In July, Cruz was pregnant and in a crisis caused by a virus doctors were only starting to recognize. The physicians phoned the federal Centers for Disease Control and Prevention. A virologist there crunched the data and responded: She's probably not going to make it.

As the federal government starts rolling out an injectable vaccine for the H1N1 virus next week, ahead of what's expected to be an unusually difficult flu season, pregnant women are among the first in line for the shots.

The global H1N1 pandemic carries special alarm for them because they are likely to get sicker. As of late August, 28 pregnant women nationwide had died from H1N1, and 100 had been hospitalized in intensive care, according to the CDC.

That's because pregnancy, especially in the last trimester, is an immuno-compromised state, said Dr. Christian Sandrock, an infectious disease specialist at the University of California Medical Center in Sacramento. No one young is immune to H1N1, and pregnant women's weak immune systems make them more susceptible to it than other young people.

"The seasonal flu they handle better because presumably they've been infected with the flu before," Sand- rock said. "And the strains are closely related enough that pregnant women are able to respond to it with some immunity."

Not alarmed at first

In mid-July, Cruz was 27 weeks pregnant and certainly felt as though her immune system was compromised. Yet it was benign thoughts — allergies, a common cold — that ambled through her mind.

Then her temperature began to fluctuate, followed by an unrelenting cough and night terrors. Still, she wasn't overly concerned.

Kevin Briscoe, her fiancé, frequently checked on her, even at work during his lunch breaks. On July 20, he was debating whether to drive home, or save the gas money and stay at work.

He called Cruz; he felt a twinge of anxiety when she didn't pick up or respond quickly like she often did via her BlackBerry. By the time Briscoe had driven home, Cruz was delirious.

"I was talking to her and it was like she was in a nightmare," Briscoe said. "She was looking right through me."

An ambulance rushed the semiconscious Cruz to Mercy San Juan Medical Center in Carmichael, where doctors intubated her and hooked her up to an artificial breathing machine in the intensive care unit. In addition to the H1N1 virus, Cruz's lungs were about 90 percent waterlogged from pneumonia.

A team of doctors fretted. At that point, they had not yet cared for a pregnant patient with the H1N1 virus. In the summer, during the early stage of the pandemic, rumors had swirled without much scientific evidence.

"I had to tell her family that she was very sick, and that people like this can go into multisystem organ failure and even die," said Dr. Amit Karmakar, the pulmonary critical care specialist who took care of Cruz in Mercy San Juan's ICU.

Concerns about the baby

Two weeks passed and Cruz still wasn't stable. Worried her fetus wouldn't get enough oxygen, doctors turned the ICU into an operating room and performed a Caesarean section while Cruz was unconscious on paralytic medication.

Kevin Briscoe Jr. was born 10 weeks early, slightly anemic but miraculously illness-free. But Cruz remained unconscious. The 3-pound preemie stayed in the neonatal ICU, and as he matured, Mercy San Juan nurses decorated Cruz's bed with photos of him.

Finally, in late August, she regained consciousness. But she couldn't remember a thing.

"When they first brought my baby to me I didn't know it was my child," she said. "I was confused."

Since then it's been a gradual recovery for Cruz, who still uses a wheelchair, though she has started to walk again.

Briscoe and Cruz chose today to get married because it is Kevin Jr.'s original due date.

The couple are an example of the classic opposites attract: She is shy; he is the life-of-the-party jokester. She was ready to get married; he dragged his feet.

They almost got married while Cruz was in the hospital. Looking at her while she was on life support, Briscoe felt an urgency he hadn't experienced during their nine-year engagement.

He wanted to get married so badly he pleaded with the hospital to let them do it there.

It was Cruz who postponed the marriage one last time: She was afraid her mother would be mad.

The 40-person wedding still feels a bit grandiose for Cruz: A friend had to drag her out to pick a wedding gown.

"I guess it took this near-death experience to get us down the aisle," Briscoe joked.

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