[Management of HIV-positive pregnancies -- results from a retrospective study].
OBJECTIVE
The management of HIV-positive pregnancies was investigated in conjunction to pre-, peri and postpartal complications and the HIV transmission rate.


METHODS
Retrospective study of 88 HIV-positive patients who were delivered at the Dept. of Obstetrics and Gynaecology during 1.1.1997-31.12.2001.


RESULTS
HIV-positive patients showed significantly more prepartal complications, compared to control group. Low CD4-cell count (< or = 200/microl) or high viral load (> 10 000 HIV-copies/ml) was not associated with increased risk for transmission relevant complications. The overall HIV-transmission rate was 3.4 % (3/89 newborns; with ART 2.5 % [2/85], without ART 33.3 % [1/3]). The transmission rate increased with complications during pregnancy (7.7 % [2/26] vs. 1.6 % [1/61]). Newborns delivered < or = 35 (th) week of gestation showed a transmission rate of 5.3 % compared to 2.9 % of newborns delivered after the 35 (th) week of gestation. 98 % of the patients were delivered by cesarean section (primary: n = 71, prior: n = 15), spontaneously: n = 2). 97 % of patients (85/88) were treated with antiretroviral therapy (ART). No differences were found in the postpartal complication rate of HIV-positive to -negative patients. None of the newborns was breast fed.


CONCLUSIONS
Treatment of this risk-pregnancies in HIV experienced centers significantly reduces the risk of HIV transmission.
Ahr
A
A
Zentrum für Frauenheilkunde der J.W.G.-Universität Frankfurt/M. Ahr@em.uni-frankfurt.de
Faul-Burbes
C
C
Haardt
N
N
Linde
R
R
Haberl
A
A
Bremerich
D
D
Kissler
S
S
Schloesser
R
R
Kaufmann
M
M
D005260:Female; D006679:HIV Seropositivity / Q000635:transmission*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000821:virology*; D012189:Retrospective Studies