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Pregnancy and HIV: how to reduce the risk of infection of the child?

22.03.2021 Today, many are convinced that the diagnosis of HIV is a death sentence, and a woman with such a disease should never give birth. But the fact of the birth of healthy children to HIV-infected mothers convinces us of the opposite.

Now more and more questions related to HIV and pregnancy arise: is it possible to protect a child from this disease, what are the chances of having a healthy baby, will pregnancy and childbirth worsen the course of HIV infection itself in the mother?

Give birth or interrupt? Give birth to!

Contrary to common misconception, HIV infection is not a medical indication for termination of pregnancy. Whether to give birth or terminate a pregnancy is a decision that ultimately rests with the woman herself. Nobody has the right to put pressure on her. However, a pregnant woman needs to approach this issue with all responsibility.

First, it is necessary to undergo a thorough examination and be sure to register with the AIDS Center if the pregnant woman found out about her diagnosis already in an “interesting” position. The doctor should tell about whether there is a high risk of infection, indications for termination of pregnancy.

About the risks of infection.

All HIV-positive people should be aware that an HIV-positive woman can give birth to a healthy baby. HIV is not a reason to give up starting a family and planning a pregnancy.

If a woman regularly receives therapy during pregnancy, the risk of infecting a child is reduced to 2%. If the woman does not do anything, then the probability of HIV transmission from mother to child will be 13-50%. This percentage depends on a number of factors - high viral load, low immunity, the presence of concomitant pathology (diseases of the kidneys, cardiovascular system, diabetes and others), sexually transmitted infections (STIs), the presence of viral hepatitis B and C, smoking, alcohol and drug use.

A woman can reduce the risk of infecting her child by following a healthy lifestyle, being monitored in an antenatal clinic and at the AIDS Center, regularly taking chemoprophylaxis.

Antiretroviral therapy. Pregnancy and HIV: what influences what?

It is important to touch upon the question of how pregnancy affects the development of HIV infection. In any woman, whether she is infected or not, during pregnancy, the body's immune function is suppressed. In HIV-infected women, immunity is already reduced, so there is a danger that pregnancy in this case can accelerate the development of the infection itself.

In this connection, in the AIDS Center, a woman in a position according to an individual scheme is prescribed chemoprophylaxis (combined highly active antiretroviral therapy), intended specifically for pregnant women. The expectant mother receives these drugs free of charge at the Center. Thanks to regular and correct use, the risk of infection of the child is reduced by less than 2%.

Unfortunately, it is impossible to reduce the risk of HIV transmission from mother to child to zero, even using all modern methods. Therefore, the most important thing in the desire to become a mother is to take all measures to give birth to a healthy child.

Safe childbirth.

Vaginal childbirth, compared to caesarean section, does not pose a risk for an HIV-infected mother and her unborn baby. As a rule, a caesarean section is prescribed for an unknown or high viral load (more than 1000 copies of HIV RNA per 1 ml of blood). Therefore, if the mother has a low viral load and all precautions have been taken for the birth of a new person, then natural (vaginal) childbirth is prescribed.

In any case, the decision on the mode of delivery is made in accordance with each specific obstetric situation, depending on various factors.

Lactation.

Breastfeeding is considered one of the most common ways of transmission of HIV from mother to child, so it is important for an HIV-infected mother to completely eliminate breastfeeding of her child. The baby must be transferred to artificial mixtures, the composition of which is currently as close as possible to the composition of mother's milk, and at the AIDS Center they are issued absolutely free of charge!

LipetskHealthcare
pregnancy # uzalo48

Obstetrician-gynecologist
GUZ "Lipetsk Regional Center for Wrestling
with AIDS and infectious diseases "
Tupikina Natalia Alexandrovna

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