Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
HIV and Pregnancy Introduction • In the general obstetrical population in the United States, the frequency of HIV infection is about 1 per 1000. The prevalence is as high as 1% to 1.5% in inner-city populations. Approximately 30% of the exposed fetuses will also acquire the infection. How Can HIV/AIDS Affect Pregnancy? • In most cases, HIV will not cross through the placenta from mother to baby. If the mother is healthy in other aspects, the placenta helps provide protection for the developing infant. • Factors that could reduce the protective ability of the placenta include in-uterine infections, a recent HIV infection, advanced HIV infection or malnutrition. What Are The Chances That A Baby Will Become HIV Positive? • A baby can become infected with HIV in the womb, during delivery or while breastfeeding. • If the mother does not receive treatment, 25 percent of babies born to women with HIV will be infected by the virus. Reducing Risk Of Transmission • A multi-care approach is the most effective way for pregnant women with HIV infection to have a healthy pregnancy and delivery. • The United States Public Health Service recommends that HIV-infected pregnant women be offered a combination treatment with HIV-fighting drugs to help protect her health and to help prevent the infection from passing to the unborn baby. Reducing Risk Of Transmission • Zidovudine was the first drug licensed to treat HIV. Now it is used in combination with other anti-HIV drugs and is often used to prevent perinatal transmission of HIV. • ZDV should be given to HIV-infected women beginning in the second trimester and continuing throughout pregnancy, labor and delivery. • Side effects include nausea, vomiting and low red or white blood cell counts. Reducing Risk Of Transmission • Zidovudine is associated with a decrease in perinatal HIV transmission to 8.3%. • When care includes both zidovudine therapy and a scheduled cesarean delivery, the risk is approximately 2%. • Nursing should be discouraged because the virus is secreted in breast milk. During Delivery • The chance of transmission is even greater if the baby is exposed to HIVinfected blood or fluids. • Health care providers should avoid performing amniotomies, episiotomies and other procedures that expose the baby to the mother’s blood. • The risk of transmission increases by 2% for every hour after membranes have been ruptured. During Delivery • Cesarean sections performed before labor and/or the rupture of membranes may significantly reduce the risk of perinatal transmission of HIV. • Women who have not received any drug treatment before labor should be treated during labor with one of several possible drug regimens. • These may include a combination of ZDV and another drug called 3TC or Nevirapine. • Studies suggest that these treatments, even for short durations, may help reduce the risk to the baby. Post Delivery • The baby should be treated with ZDV for the first six weeks of life. • Eight percent of babies of women treated with ZDV became infected, compared with 25 percent of babies of untreated women. • No significant side effects of the drug have been observed other than a mild anemia in some infants that cleared up when the drug was stopped. • Follow-up studies show that the HIV-negative treated babies continued to develop normally.