title: Optimal management of HIV-infected women during pregnancy and delivery: an audit of compliance with recommendations.
abstract: BACKGROUND
  The improvement in quality of life of HIV-infected patients and a reduced risk of vertical transmission have led to an increase in the desire for pregnancy among infected women. We assessed whether local recommendations were followed by HIV-infected mothers and their reasons for noncompliance.
  
  
  METHODS
  Data on HIV-infected women who delivered between 2002 and 2006 in a large public university hospital in Brussels were collected and analyzed for compliance with recommendations and outcomes.
  
  
  RESULTS
  The evidence suggests that current recommendations were followed in two thirds of the 203 recorded deliveries, as the patients in question (n = 140) came to term with an undetectable viral load and an uninfected newborn. About half of these women delivered vaginally, and 67% had ruptured membranes for less than 4 hours and required no instrumental delivery. Among those for whom optimal conditions for delivery were not met, two newborns were infected.
  
  
  CONCLUSIONS
  The current recommendations were followed in only two thirds of the recorded deliveries. To improve results for the future, we have adapted our protocol both by starting antiviral therapy earlier and by assigning nurses to the patients' follow-up to try to promote better compliance to treatment during pregnancy.
authors: Department of Obstetrics and Gynecology, Division of Infectious Diseases, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium.
authors: Aline
authors: A
authors: Vandermaelen
authors: Patricia
authors: P
authors: Barlow
authors: Yannick
authors: Y
authors: Manigart
authors: Marc
authors: M
authors: Hainaut
authors: Tessa
authors: T
authors: Goetghebuer
authors: Jack
authors: J
authors: Levy
authors: Michèle
authors: M
authors: Gerard
authors: Serge
authors: S
authors: Rozenberg
mesh_terms: D000293:Adolescent; D000328:Adult; D001530:Belgium / Q000453:epidemiology; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000628:therapy* / Q000635:transmission*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control* / Q000706:statistics & numerical data; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010352:Patient Dropouts / Q000706:statistics & numerical data; D018743:Perinatal Care / Q000379:methods; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control; D011256:Pregnancy Outcome / Q000453:epidemiology; D012367:RNA, Viral / Q000097:blood; D055815:Young Adult
chemical_list: D012367:RNA, Viral