Scribd
Upload
68 views13 pages

Management of Pregnant Women with HIV

This study evaluated the outcomes of 6 pregnant women with vertically-acquired HIV in Indonesia between 2004-2013. All women received HAART during pregnancy and AZT during delivery. Average maternal age was 20. Four pregnancies had viral loads <1000 copies/ml at delivery while the others were >1000. All deliveries were by C-section, with 4 being urgent. Breastfeeding was avoided. Young maternal age and poor compliance contributed to prematurity and higher viral loads. Strict HAART is important to achieve maximal viral suppression during delivery and reduce perinatal transmission risk.

Uploaded by

Msharania
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
68 views13 pages

Management of Pregnant Women with HIV

This study evaluated the outcomes of 6 pregnant women with vertically-acquired HIV in Indonesia between 2004-2013. All women received HAART during pregnancy and AZT during delivery. Average maternal age was 20. Four pregnancies had viral loads <1000 copies/ml at delivery while the others were >1000. All deliveries were by C-section, with 4 being urgent. Breastfeeding was avoided. Young maternal age and poor compliance contributed to prematurity and higher viral loads. Strict HAART is important to achieve maximal viral suppression during delivery and reduce perinatal transmission risk.

Uploaded by

Msharania
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd

MANAGEMENT AND OUTCOME

OF PREGNANT WOMEN WITH


HIV ACQUIRED BY
VERTICAL TRANSMISSION
Nama pembimbing: Dr.Achmad Djaenudin,
SpOG
Dr. Prahadi Rahardjo,
SpOG
Dr. Johanes Benarto, SpOG
Disusun oleh: Sharania Manivannan

Introduction
Infection
Combine
d HAART
Aim

Death and majority children did not survive


beyond reproductive age
Decrease in pediatric AIDS deaths due to
the benefit from ARV therapy

Prolonged survival, have been able to


achieve the adulthood
Better health status, which lets them be
mothers

Evaluate the outcome of pregnant women


with HIV acquired by vertical transmission

Patients and
Methods
Retrospective study about pregnant women with verticallyacquired HIV whose pregnancies between 2004 and 2013.

Six patients delivered eight pregnancies and nine


newborns.

A female is considered to have perinatally acquired HIV


infection if her mother was infected by HIV during
pregnancy, labor or delivery, or found to be infected during
infancy or early childhood

Patients and
Methods
HIV-1 RNA VLs obtained
early and close to the time
of delivery

CD4 cell counts

Gestational age at booking


in the maternity

Preterm birth being defined


by gestational age below 37
weeks

Gestational age at delivery

Compliance, HIV treatment

Patients and
Methods

A child considered
infected if HIV-1
DNA or RNA
polymerase chain
reaction positive on
2 samples

or HIV-1 antibodies
detected at 6
months of age, or
uninfected in other
cases.

Results
All patients took HAART during pregnancy.
All pregnant received AZT during delivery (loading
dose 2 mg/kg in half an hour, and maintenance dose
1 mg/kg/hour until delivery).
All the newborns received zidovudine.
Average age of women was 20 years (range 16 - 26)
One pregnant woman suffered pneumonia, another
one was diagnosed a high-grade squamous
intraepithelial lesion (HSIL)
Average gestational age at term was 36 weeks

Results

Results
36 weeks, 4
pregnants (50%)
had viral load <
1000 copies/ml.

The other
pregnant had a
viral load> 1000
copies/ml.

Last four cases the


compliance of the
treatment was
very poor.

All pregnancies
delivered by CS,
only 4 was urgent,
one due to in labor
and 3 suffered
PROM

vaginal delivery
was possible but
refused

Breastfeeding was
artificial in all
cases.

Discussion
Young maternal age

contributes to lower compliance with measures of fetal and


maternal care

VIH pregnancies and prematurity are connected

highest viral load, delivered earlier than the other women

Worst compliance, reached higher viral load and delivered more


prematurely

HAART therapy reduces the influence of the perinatal risk


factors on vertical HIV transmission

Discussion
Viral load
<1000
copies/ml

Viral load >


1000
copies/ml

CS is safe
Vaginal deliver
y
is safe
Educate on
complications
of
CS

Low CD4 cell


count
Prematurity

Discussion
counseling on sexuality

reproductive health and


contraception

Prevent
mother-tochild
transmission
social support to achieve
proper HAART
a maximal viral
management
suppression

Conclusion
The management of pregnant women with HIV
acquired by vertical transmission is complicated,
since in most cases the women are young and the
compliance to the treatment may be poor.
Combined HAART during pregnancy should be a strict
treatment in order to achieve the maximal viral
suppression at the moment of the delivery.
When the viral load is controlled, these pregnancies
suffer complications like prematurity.

Thank you

You might also like