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ALL / Infectious Diseases
HIV and pregnancy
HIV and pregnancy
With the increased incidence of HIV infection amongst the heterosexual population there are an increasing number of HIV positive women giving birth in the UK. In London the incidence may be as high as 0.4% of pregnant women. The aim of treating HIV positive women during pregnancy is to minimise harm to both the mother and fetus, and to reduce the chance of vertical transmission.Guidelines regularly change on this subject and most recent guidelines can be found using the links provided.
Factors which reduce vertical transmission (from 25-30% to 2%)
- maternal antiretroviral therapy
- mode of delivery (caesarean section)
- neonatal antiretroviral therapy
- infant feeding (bottle feeding)
Screening
- NICE guidelines recommend offering HIV screening to all pregnant women
Antiretroviral therapy
- all pregnant women should be offered antiretroviral therapy regardless of whether they were taking it previously
Mode of delivery
- vaginal delivery is recommended if viral load is less than 50 copies/ml at 36 weeks, otherwise caesarian section is recommended
- a zidovudine infusion should be started four hours before beginning the caesarean section
Neonatal antiretroviral therapy
- zidovudine is usually administered orally to the neonate if maternal viral load is <50 copies/ml. Otherwise triple ART should be used. Therapy should be continued for 4-6 weeks.
Infant feeding
- in the UK all women should be advised not to breast feed
+PassMedicine Notes
With the increased incidence of HIV infection amongst the heterosexual population there are an increasing number of HIV positive women giving birth in the UK. In London the incidence may be as high as 0.4% of pregnant women. The aim of treating HIV positive women during pregnancy is to minimise harm to both the mother and fetus, and to reduce the chance of vertical transmission.
Guidelines regularly change on this subject and most recent guidelines can be found using the links provided.
Factors which reduce vertical transmission (from 25-30% to 2%)- maternal antiretroviral therapy
- mode of delivery (caesarean section)
- neonatal antiretroviral therapy
- infant feeding (bottle feeding)
- NICE guidelines recommend offering HIV screening to all pregnant women
- all pregnant women should be offered antiretroviral therapy regardless of whether they were taking it previously
- vaginal delivery is recommended if viral load is less than 50 copies/ml at 36 weeks, otherwise caesarian section is recommended
- a zidovudine infusion should be started four hours before beginning the caesarean section
- zidovudine is usually administered orally to the neonate if maternal viral load is