title: Amniocentesis in HIV pregnant women: 16 years of experience.
abstract: The iatrogenic risk of HIV vertical transmission, calculated in initial epidemiologic studies, seemed to counterindicate invasive prenatal diagnosis (PND) procedures. The implementation of highly active antiretroviral therapy (HAART) represented a turning point in PND management, owing to a rapid and effective reduction of maternal viral load (VL). In the present study, we identified cases of vertical transmission in HIV-infected pregnant women who did amniocentesis in the second trimester of pregnancy (n = 27), from 1996 to 2011. We divided our sample into Group A--women under HAART when submitted to amniocentesis (n = 20) and Group B--women without antiretroviral therapy before amniocentesis (n = 7). We had 1 case of vertical transmission in Group B. Preconceptional or early first trimester HIV serology is essential to avoid performing an amniocentesis without antiretroviral therapy or viral suppression. When there is an indication for amniocentesis in an HIV-infected pregnant woman, it should be done if the patient is on HAART and, if possible, when VL is undetectable. Nowadays, with combined first trimester screening test to select pregnancies with high risk of aneuploidies, advanced maternal age is a less frequent indication to perform PND invasive procedures, representing an outstanding gain in prenatal diagnosis of this population.
authors: Obstetrics/Gynecology, Maternidade Dr. Alfredo da Costa, Lisbon, Portugal. mafaldamartinhosimoes@gmail.com
authors: Mafalda
authors: M
authors: Simões
authors: Catarina
authors: C
authors: Marques
authors: Ana
authors: A
authors: Gonçalves
authors: Ana Paula
authors: AP
authors: Pereira
authors: Joaquim
authors: J
authors: Correia
authors: João
authors: J
authors: Castela
authors: Cristina
authors: C
authors: Guerreiro
mesh_terms: D000328:Adult; D000649:Amniocentesis / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000635:transmission*; D006801:Humans; D007049:Iatrogenic Disease; D018445:Infectious Disease Transmission, Vertical; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000821:virology*; D011262:Pregnancy Trimester, Second
chemical_list: D044966:Anti-Retroviral Agents
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