کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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3922195 | 1599875 | 2008 | 6 صفحه PDF | دانلود رایگان |
![عکس صفحه اول مقاله: Current guidelines on management of HIV-infected pregnant women: Impact on mode of delivery Current guidelines on management of HIV-infected pregnant women: Impact on mode of delivery](/preview/png/3922195.png)
ObjectiveTo evaluate acceptance, feasibility and difficulties in the application of a policy of vaginal delivery in selected cases in HIV-infected women.Study designHIV-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 >1000 copies/mL. Main outcome measures were mode of delivery, prematurity, acceptance of vaginal delivery and mother-to-child transmission of HIV infection.ResultsThe 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%).ConclusionRecommending 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.
Journal: European Journal of Obstetrics & Gynecology and Reproductive Biology - Volume 139, Issue 2, August 2008, Pages 127–132