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HIV in Pregnancy PDF
HIV in Pregnancy PDF
:
( )
HIV 3
.. 2553 6,000
3.6
HIV 3
1. 9 23
2. 24 48 65
3. 12
1 HIV (HIV RNA level)
2 CD4 count
3 34
4 4
1. HIV HIV
2. HIV
3.
4. HIV
(2553)
HIV
HIV HIV
HIV CD 4 3
VL 36
HIV
HIV
HIV
HIV
2-8
: HIV in Pregnancy
HIV
(Pretest Counseling)
Anti HIV (Inform consent)
Positive
(Posttest Counseling)
Psychological support
HIV
CD4 VL
(High risk pregnancy)
Negative
Window period
3 - 6
HIV
3-8
: HIV in Pregnancy
1.
.. 2554
(HAART)
CD4
(2)
(3)
AZT (300 .) 1 x
3 .
AZT (600 .)
< 350(1)
AZT +3TC+LP/r
> 350
AZT +3TC+LP/r
14
(4)
AZT x 4
18
4-8
: HIV in Pregnancy
CD4 count
- 6
Viral load
- 36
CBC
-
- AZT 8
- Hb < 8 g/dl Hct < 24% Hb < 8 g/dL Hct < 24%
AZT d4T
AZT d4T
AZT 3
ALT
- 2.5
upper limit NVP
-
2.5 upoer limit
EFV LPV/r
NPV
Urine sugar
- LPV/r
- LPV/r
24 28 LPV/r
4
blood sugar 1 . 140 mg%
OGTT
CD4
5-8
: HIV in Pregnancy
Scalp electrodes ,
ARM, F/E ,V/E
AZT
300 . 3 AZT 600 mg
AZT
SD NPV AZT mono therapy
CD4
- AZT syrup 4 mg/kg/dose 12 .
4
- SD NPV
SD NPV
6-8
: HIV in Pregnancy
Anti HIV no ANC
Anti HIV
Pretest counseling
Rapid test
Negative
Positive
Posttest counseling
HIV
3
Neg
Test 3
Neg
Pos
Test 2
Pos
Posttest counseling
7-8
: HIV in Pregnancy
(HAART)
CD4
< 350(1)
> 350
(2)
- NVP x 2 4
AZT +3TC+LP/r
+ SD. NVP(1)
- 18
4
(1) 2
(2) AZT
4 ./. x 12
3 TC
2 ./. x 12
NVP
4 ./. x
NPV + AZT + 3 TC
- NPV syrup 4 mg/kg 24 . 2 4
- AZT syrup 4 mg/kg 12 .
- 3 TC syrup 2 mg/kg 12 . 4 6
( AZT + 3 TC NPV 2
48 .
48 .
1.
-
- 4 .
2. elective caesarean section
- 2 .
- HAART
- 4
- Viral load 36 1,000 copies/mL
8-8
: HIV in Pregnancy
PPROM occurs after 34 week of gestation, Augmentation may be considered if the viral load less than 50
copies/ml and there are no obstetric contraindications
PPROM occurs before 34 week of gestation , national guidelines for the general population
Prolonged pregnancy :
-
on HAART with plasma viral load of less than 50 copies/ml no contraindication to membrane sweep or to use
of prostaglandins.
Reference
1. National Guidelines on HIV/AIDS Diagnosis and Treatment : Thailand 2010
2. Management of HIV in Pregnancy, RCOG Green-top Guideline 2010
3. Recommendations for Use of Antiretroviral Drugs in Pregnant HIV - 1 Infected Women for
Maternal Health and Interventions to Reduce Perinatal HIV Transmission in the United States.
Sep. 14, 2011 ; pp 1 207