DISCUSSION

In response to new research finding, the care of HIV positive

pregnant women has responded with changing trends in ART
strategy, improved virological control and choice of delivery mode.

This project provides a valuable insight into the real-life

management of HIV in pregnancy where evidence and
guidelines have been put into practice.

The National Study of HIV in Pregnancy and Childhood

(NSHPC) is a comprehensive population-based surveillance
study of paediatric and obstetric HIV.

The NSHPC reported a decline in national transmission rates

from 1.4% in 2002-2003 to 0.5% in 2010-2011.
Despite optimal management during pregnancy and the
neonatal period, MTCT HIV remains a risk and women
should be counselled accordingly.

Introduction of cabergoline offered to all women after

delivery to support them to not breastfeed and reduce the
risk of transmission via this route.

Since this review was performed, BHIVA have modified

their guidelines so that all women should be advised not
to breastfeed.

Ongoing reporting of ART use in pregnancy will enable

increase clinician confidence and patient’s choice.
 CONCLUSION

Care of the HIV positive pregnant woman in Brighton has been

successful with overall transmission consistent with that seen
nationally. Despite effective preventative strategies MTCT remains a
risk and women should be counselled accordingly.