PREGNANCY DAYS For most pregnant women, carrying a baby to term is largely a mysterious process. This section helps new parents answer some of the most important questions about pregnancy and childbirth.

HIV in Pregnancy 

• Why should I know about this infection?
• How will I be diagnosed?
• Effect of pregnancy on HIV  Disease
• Effect of HIV on pregnancy
• Transmission in my baby and risk factors
• Counseling and contraception
• Chances of having a normal child

Why should I know about this infection?

HIV infection is becoming rampant and concern for the mother’s health and prevention of this infection in the generations to come is taking predominant importance today.

The risk for perinatal transmission (ie tranfering this infection to the baby during pregnancy and for 6 weeks after delivery) in a non- breastfed baby is 15 to 20 % and in breast fed individuals, it ranges from 25%to 40%.

WHAT IS MOST IMPORTANT IS THAT THIS RISK CAN BE REDUCED TO 2% BY

• Mother using anti-retroviral therapy
• Delivery by Elective Cesarean section
• Avoidance of Breast Feeding

HIV SCREENING DURING PREGNANCY

It is recommended to carry out routine test voluntarily in all pregnant women with appropriate counseling. You can decline the test but it is in every ones favor if you do it. Screening of only high-risk group is not recommended in this case as there may be many asymptomatic, unsuspecting groups of patients suffering from HIV infection also.

EFFECT OF PREGNANCY ON HIV DISEASE PROGRESSION

It has been noticed that HIV infection itself, maybe because of hormonal changes, or because of pregnancy - related suppression of cellular immunity leads to an acceleration in the disease progression.

EFFECT OF HIV DIEASE ON PEGNANCY

HIV infection, especially when more advanced, may adversely affect pregnancy outcome and there is a possibility of spontaneous abortion, fetal growth restriction, low birth weight, preterm birth but THERE IS NO INCREASE IN CONGENITAL MALFORMATIONS.

Also the mother is more susceptible to certain infections or alteration in their natural course/treatment or increased perinatal transmission. These include -

• vulvovaginal candidiasis
• bacterial vaginosis
• genital herpes
• syphilis
• human papillomavirus infection
• cytomegalovirus infection
• toxoplasmosis
• hepatitis B and C.

WHEN DOES THIS INFECTION GO TO MY CHILD?

THE INFECTION CAN GET TRANSMITED DURING PREGNANCY, LABOR, DELIVERY OR BREAST FEEDING.

WHAT CAN INCREASE THE RISK OF TRANSMISION?

• If the type of HIV infection is virulent and the levels of CD4 counts are high.
• AIDS related symptoms
• Vitamin A deficiency
• Smoking
• Substance abuse
• Sexually Transmitted Diseases in the mother
• Prolonged labor
• Ruptured membranes
• Episiotomy
• Operative vaginal delivery
• Invasive fetal monitoring
• Chorioamnionitis
• Placental abruption
• Preterm child
• Breast feeding

ELECTIVE CESAREAN SECTION PERFORMED PRIOR TO RUPTURED MEMBRANES OR LABOR ONSET (APPROX. 38 WEEKS) REDUCES VERTICAL TRANSMISSION   TO LESS THAN 2%

PREPREGNANCY COUNSELING AND CONTRACEPTION

• Appropriate counseling is a must in all detected cases. Good nutrition, lifestyle changes, avoidance of substance abuse, and hepatitis B immunizations have to be stressed upon. Also counseling of husband would be apt.
• Consistent condom (both male and female) use must be stressed upon
• Hormonal contraception can also be taken in addition
• Anti retroviral therapy must be taken throughout the pregnancy and also during labor.

WHAT ARE THE CHANCES OF ME HAVING A NORMAL CHILD

If you and your doctor take appropriate precautions .immediate action and treatment, there in a 98% possibility of you having a normal child and a normal life. Take good care of yourself, be positive and enjoy the pregnancy and your baby. Leave the rest to science and God.

CORD BLOOD TESTING IS TO BE AVOIDED IN PREGNANCY AND HIV-DNA PCR TEST IS USED IN NEWBORN FOR EARLY DIAGNOSIS.IT IS 93% ACCURATE.

So it becomes very important to get yourself diagnosed early. Not only to increase the chances of having a normal pregnancy but also to have a happy non complicated pregnancy .