Management of HIV infection in pregnancy

Prenatal care -

• All clients should be offered voluntary serologic testing for HIV infection.
• In seropositive cases additional investigation should be done to test for other STD's.
• Husband should be offered serological test for HIV.
• Counselling about the risk of HIV transmission to the fetus and neonates should be made and termination of pregnancy offered.
• Progressive of the disease is assessed by CD-4, T-lymphocyte count and HIV RNA.
• Assessment is done at every 3-4 months internal.

Care during intrapartum period - 

• Zidovudine is given IV infusion starting at the onset of labour (vaginal delivery) or 4 hours before caesarean section.
• Mechanical suctioning devices should be used to remove secretions from the neonates airways.
• Health care workers should be protected from contact with potentially infected body fluids.
• Disposable syringes and needles are used and they are deposited in the puncture proof containers.

Postpartum care -

• Mother must be counselled about risk and benefits of breast feeding and helped to make an informed choice.
• Zidovudine syrup 2 mg/kg is given to the neonates four time daily for first 6 weeks.
• Mother should be encouraged to manage the babies care herself with the support of midwife.
• Glove must be worn for examination the perineum, lochia and caesarean wound.
• Disposal of sanitary napkin and disinfection and cleaning of any spilled blood must be done correctly.

Contraceptive method -

Barrier method of contraception (condom or female condom) is effective in preventing transmission of virus. Thus the disease could be prevented predominantly by health education and by practice of safer sex.


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