The transmission of AIDS can happen during pregnancy, delivery, or breastfeeding, and therefore, what the HIV positive pregnant woman must do to avoid contamination of the baby includes taking the medications indicated by the doctor, having a cesarean section, and not breastfeeding the baby.
Here are some useful information about prenatal care and childbirth for women with HIV.
How is the prenatal care of pregnant women with HIV
The prenatal care of pregnant women with HIV + is a little different, requiring more care. In addition to the tests normally performed during pregnancy, the doctor may order:
- CD4 cell count (every quarter)
- Viral load (every quarter)
- Liver and kidney function (monthly)
- Blood count (monthly)
These tests are important because they help in the assessment, staging, and indication of the antiretroviral regimen, and can be performed in reference centers for AIDS treatment. In patients diagnosed with HIV before pregnancy, these tests should be ordered as needed.
All invasive procedures, such as amniocentesis and chorionic villus biopsy, are contraindicated because they increase the baby’s risk of infection and therefore, in the case of suspected fetal malformation, ultrasound, and blood tests are the most indicated.
Vaccines that can be administered to HIV + pregnant women are:
- A vaccine against tetanus and diphtheria;
- Hepatitis A and B vaccine;
- Flu’s vaccine;
- Chickenpox vaccine.
The triple viral vaccine is contraindicated in pregnancy and yellow fever is not indicated, although it can be administered in the last trimester, in case of extreme need.
Treatment for AIDS in pregnancy
If the pregnant woman still does not take HIV drugs, she should start taking between 14 and 28 weeks of gestation, with the intake of 3 oral remedies. The most commonly used drug for the treatment of AIDS during pregnancy is AZT, which decreases the baby’s risk of infection.
When the woman has a high viral load and a low amount of CD4, treatment should not be continued after delivery, to prevent the woman from developing serious infections, such as pneumonia, meningitis or tuberculosis.
Side effects caused by AIDS medications in women during pregnancy include a decrease in red blood cells, severe anemia and liver failure. In addition, there may be an increased risk of insulin resistance, nausea, abdominal pain, insomnia, headache and other symptoms that must be reported to the doctor so that the antiretroviral regimen can be checked, because in some cases it may be necessary to change the combination of medicines.
Apparently the drugs do not negatively affect babies, although there are reports of cases of babies with low birth weight or premature birth, but which could not be related to the mother’s use of the drugs.
How is delivery
The delivery of pregnant women with AIDS must be an elective cesarean section at 38 weeks of gestation, so that AZT can run in the patient’s vein at least 4 hours before the baby is born, thus decreasing the chance of vertical transmission of HIV to the fetus.
After delivery of the pregnant woman with AIDS, the baby must take AZT for 6 weeks and breastfeeding is contraindicated, and formula of powdered milk must be used.
How to know if your baby has HIV
To find out if the baby has been infected with the HIV virus, three blood tests should be performed. The first should be done between 14 and 21 days of life, the second between the 1st and 2nd month of life and the third between the 4th and 6th months.
The diagnosis of AIDS in the baby is confirmed when there are 2 blood tests with a positive result for HIV. See what the symptoms of HIV in the baby may be.
AIDS medications are provided free by SUS as well as milk formulas for the newborn.