title: Outcome of pregnancy in HIV-positive women planned for vaginal delivery under effective antiretroviral therapy.
abstract: This retrospective cohort study was conducted at Newham University Hospital, London to investigate maternal outcome of planned vaginal delivery as well as rate of maternal-to-child transmission. Between June 2004 and June 2006, 23 (16%) women of 144 HIV-infected pregnant women opted for planned vaginal delivery. Offer of vaginal delivery was based on maternal HIV RNA count <50 cells/ml around 36 weeks' gestation. All women received antiretroviral therapy. Fifteen (65%) women achieved vaginal delivery. Babies were followed up over 18 months. All babies had antiretroviral prophylaxis. No babies were breast-fed. There was no report of maternal-to-child transmission in any of these babies. Our study suggests that planned vaginal delivery could be safe with antiretroviral therapy in pregnancy, optimal intrapartum care, viral load of <1000 copies/ml at delivery, retroviral prophylaxis for babies and avoidance of breast-feeding.
authors.affiliation: Department of Obstetrics and Gynaecology, Newham University Hospital, London, UK. shahedaislam@yahoo.co.uk
authors.forename: S
authors.initials: S
authors.lastname: Islam
authors.forename: V
authors.initials: V
authors.lastname: Oon
authors.forename: P
authors.initials: P
authors.lastname: Thomas
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000635:transmission; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000209:etiology*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D047929:Term Birth; D019562:Viral Load; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents