The U.S. Public Health Service has recommended that HIV-infected pregnant women should receive treatment with antiretroviral drugs as though they were not pregnant. If a woman is diagnosed in her first trimester, she should be evaluated and treated. Depending on lab test results, she may be able to postpone treatment until the second trimester when drug-related risks to the fetus are lower. If an HIV-infected woman is already on medications prior to pregnancy, she should continue the drugs. While the risk that the drugs pose to the fetus are not completely clear, they appear to be low. However, efavirenz is known to cause birth defects and should be avoided. Drug treatment during pregnancy greatly reduces the risk that HIV will be transmitted to the fetus or newborn. With new treatments that are available, the risk of a treated mother passing on the infection to her baby has been reduced to 2%.
Both the fetus and the newborn of a mother who is HIV positive are vulnerable to infection. Infection can occur in utero, during labor and delivery, or from breast feeding. To avoid transmitting the infection from mother-to-child, a woman who knows she is HIV positive should be carefully monitored and ideally should receive 500 to 600 mg Zidovudine (ZDV), divided into 2 to 5 doses daily, starting at 14 to 34 weeks of pregnancy, Together the physician and mother will determine whether vaginal delivery or C-section should be performed. Vaginal delivery of HIV infected mothers may be advised if viral load is <1000 copies. The mother-to-child transmission may be higher in vaginal delivery, but the caesarean delivery carries an increased risk of infection for the mother, as well as other surgery-related complications.
In order to minimize the danger of transmission of HIV to the infant, the mother should receive IV ZDV during labor. For a Caesarean delivery, the ZDV should be started 3 hours before delivery and continue until delivery. For a vaginal delivery, IV ZDV should be given throughout labor and delivery. With either type of delivery, the infant should receive anti-HIV drug treatment, usually 6 weeks of ZDV, for prevention of mother-to-child transmission. Mothers with HIV should not breast feed their infants because HIV can be transmitted through breast milk.
Both the fetus and the newborn of a mother who is HIV positive are vulnerable to infection. Infection can occur in utero, during labor and delivery, or from breast feeding. To avoid transmitting the infection from mother-to-child, a woman who knows she is HIV positive should be carefully monitored and ideally should receive 500 to 600 mg Zidovudine (ZDV), divided into 2 to 5 doses daily, starting at 14 to 34 weeks of pregnancy, Together the physician and mother will determine whether vaginal delivery or C-section should be performed. Vaginal delivery of HIV infected mothers may be advised if viral load is <1000 copies. The mother-to-child transmission may be higher in vaginal delivery, but the caesarean delivery carries an increased risk of infection for the mother, as well as other surgery-related complications.
In order to minimize the danger of transmission of HIV to the infant, the mother should receive IV ZDV during labor. For a Caesarean delivery, the ZDV should be started 3 hours before delivery and continue until delivery. For a vaginal delivery, IV ZDV should be given throughout labor and delivery. With either type of delivery, the infant should receive anti-HIV drug treatment, usually 6 weeks of ZDV, for prevention of mother-to-child transmission. Mothers with HIV should not breast feed their infants because HIV can be transmitted through breast milk.
No comments:
Post a Comment