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Current guidelines on management of HIV-infected pregnant women: Impact on mode of delivery

Authors :
Suy, Anna
Hernandez, Sandra
Thorne, Claire
Lonca, Montserrat
Lopez, Marta
Coll, Oriol
Source :
European Journal of Obstetrics & Gynecology & Reproductive Biology. Aug2008, Vol. 139 Issue 2, p127-132. 6p.
Publication Year :
2008

Abstract

<bold>Objective: </bold>To evaluate acceptance, feasibility and difficulties in the application of a policy of vaginal delivery in selected cases in HIV-infected women.<bold>Study Design: </bold>HIV-infected women delivering March 2002 to December 2004 and enrolled in a prospective observational study in a University hospital tertiary care center were included. A vaginal delivery was not considered if labor before 36 weeks of pregnancy, preterm premature rupture of membranes, on non-highly active antiretroviral therapy (HAART) or viral load >1000copies/mL. Main outcome measures were mode of delivery, prematurity, acceptance of vaginal delivery and mother-to-child transmission of HIV infection.<bold>Results: </bold>The study included 91 pregnancies, with a total of 95 fetuses. Eighty percent (n=73) of women knew their HIV infection status before becoming pregnant and 57 (63%) were on HAART at conception. Median gestational age at delivery was 37 weeks (range 22-41). Twelve women delivered a live-born before 36 weeks, all with a caesarean section. Among 74 women who reached 36 weeks gestation, 47 (64%) met the pre-established criteria for vaginal delivery, of whom 21 (45%) delivered vaginally. The most common reason for not having a vaginal delivery was the woman's request for a caesarean section. No cases of HIV vertical transmission occurred (0/90, 95% CI 0-4.02%).<bold>Conclusion: </bold>Recommending vaginal delivery among HIV-infected women in selected cases was well accepted, particularly once the policy became established. Nevertheless, a high proportion of HIV-infected women will continue to require caesarean section delivery. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
03012115
Volume :
139
Issue :
2
Database :
Academic Search Index
Journal :
European Journal of Obstetrics & Gynecology & Reproductive Biology
Publication Type :
Academic Journal
Accession number :
33530072
Full Text :
https://doi.org/10.1016/j.ejogrb.2007.12.007