Right after proving the pregnancy through a blood test or beta HCG as indicated by the doctor, the obstetrician will request the first prenatal tests , among them to check for possible HIV during pregnancy. All of these tests are extremely important to assess the health conditions of the mother and thus provide support and monitoring for a healthy fetal development.
If HIV is discovered early in pregnancy, specific treatment will be given and the chances of the baby being born carrying the virus will drop dramatically. During pregnancy the disease has an accelerated evolution and if the medication is not started, there is a 20% chance of the baby acquiring the virus through pregnancy, childbirth or even breastfeeding . During pregnancy, the virus can be transmitted through the placenta , during delivery on contact with contaminated blood and fluids and on breastfeeding by the milk produced that also carries the virus since it is produced by an infected body.
Another very important point for requiring more rigorous monitoring in the case of HIV during pregnancy, is the fact that HIV-positive women are more likely to have complications throughout pregnancy due to their immune system being weakened. Premature birth, spontaneous abortion and impaired fetal growth are risks presented for this type of pregnancy.
How is the treatment for pregnant women with HIV?
As soon as HIV is discovered during pregnancy, the obstetrician will refer you for an appointment with an infectious disease specialist who should accompany the pregnancy in partnership. Complementary tests will be requested to prove the existence of the virus and to check the viral load and CD4 cell count in the blood, cells that are responsible for the defense of the body. Through these tests, treatment will be indicated, usually by treating with the AZT drug that will reduce the chances of HIV transmission to the fetus. In the case of women who are already aware of the disease and become pregnant, they should not pause the use of medications, because without the medication the virus will become even more resistant, so the infectious disease physician must be informed immediately for further guidance.
In some cases the infectious disease specialist may recommend treatment only in the second trimester of pregnancy, this will depend on the mother’s health and how her immunity will be. In the second trimester the main organs of the fetus have already been formed and will not receive the medication. At the time of delivery, the medication should be administered intravenously about 3 to 4 hours before delivery . Usually in the case of HIV during pregnancy, cesarean delivery is indicated so that the risks of contamination of the baby are reduced. Since during normal delivery, when the bag is broken, fluid exchange between mother and child is inevitable. Other precautions such as not doing vaginal touches, episiotomy or inducing labor as well as using forceps in this case, are not indicated.
AZT medication is administered to the baby shortly after birth and must be maintained for six weeks , where the test will be carried out, ruling out or not transmitting the virus. After two weeks it is already reliable to do a test to check if the virus is active, but the result will only be 100% guaranteed after a few months where the antibodies transmitted by the mother will have already left the child’s body. Regarding breastfeeding, the obstetrician and the infectologist responsible for prenatal care should instruct the mother not to breastfeed her baby . This is on the recommendation of the Public Ministry of Health, and the exchange for artificial milk is indicated. In the maternity ward, the use of medication to inhibit the production of breast milk will be advised.
My name is Dr. Alexis Hart I am 38 years old, I am the mother of 3 beautiful children! Different ages, different phases 16 years, 12 years and 7 years. In love with motherhood since always, I found it difficult to make my dreams come true, and also some more after I was already a mother.
Since I imagined myself as a mother, in my thoughts everything seemed to be much easier and simpler than it really was, I expected to get pregnant as soon as I wished, but it wasn’t that simple. The first pregnancy was smooth, but my daughter’s birth was very troubled. Joana was born in 2002 with a weight of 2930kg and 45cm, from a very peaceful cesarean delivery but she had already been born with congenital pneumonia due to a broken bag not treated with antibiotics even before delivery.