HIV Positive And Pregnant
If the mother has HIV infection, the baby can become infected during pregnancy, during labour and delivery, or even during breastfeeding. Therefore, it is imperative for all pregnant women to undergo screening for HIV infection on their first visit to an antenatal clinic.
The idea behind this confidential test is not to discriminate the mother, but to start anti-retroviral therapy early on in the pregnancy, to prevent mother to child transmission, This way, a HIV positive pregnant lady can give birth to a healthy baby who will not contract the infection. Also, according to research, pregnancy does not appear to worsen HIV or increase the risk of death from HIV, so this encourages a HIV positive woman to become pregnant.
The human immunodeficiency virus, commonly known as HIV, attacks the immune system and is transmitted through sexual intercourse, blood transfusions or from mother to child during pregnancy or labour. It is a retrovirus infection and treatment with effective ‘highly active antiretroviral therapy’ not only leads to a long and healthy life in the general population but also greatly reduces the chance of mother to child transmission.
A HIV positive woman must be under the care of both an obstetrician and an HIV specialist. Blood tests to determine the magnitude of the HIV virus In the blood (HIV viral load) and the strength of the immune system (the number of CD4 T cells) must be done.
“If the mother has HIV infection, the baby can become infected during pregnancy, during labour and delivery, or even during breastfeeding”
Other blood tests to evaluate general health of the woman and to monitor side effects of medications must also be conducted. During the pregnancy, all women with HIV are advised to take antiretroviral drugs throughout the pregnancy period because with the administration of anti-HIV medication, there is a chance of reducing the extent of the virus in the body during pregnancy.
In the absence of treatment, the risk of this form of transmission of HIV is as high as 25-30 per cent. The greatest risk factor for neonatal transmission is advanced maternal disease. Compliance to retroviral therapy is important, as is, avoiding cigarette smoking, concurrent use of drugs (cocaine, heroin) and unprotected intercourse as these factors are associated with increased risk of transmission to a newborn.
A scheduled caesarean delivery about two weeks before the delivery date that is at 38 weeks, has shown to reduce of the transmission of the ailment from mother to child. However, it a woman goes into labour, a caesarean delivery may not reduce the risk of mother-to- child transmission.
“In the absence of treatment, the risk of this form of transmission of HIV is as high as 25-30 percent”
With the implementation of HIV testing, counselling, antiretroviral medication and delivery by caesarean section prior to onset of labour, mother-to-infant transmission can be reduced to as low as two per cent.
Additionally, babies receive antiretroviral medication for at least six weeks when they are born to HIV positive women. This administration of medication reduces the risk of any infection from HIV that may have entered the babies’ bodies during delivery.
The infection can also be transmitted through breast milk. However, the question to breast teed or not, should be evaluated on an individual basis. In an ideal situation, breast feeding is contraindicated in HIV positive mothers because there is chance of transmission of infection even though, the risk ¡s small. However, in cases of poverty, where safe water and formula feeds are not available, breast feeding is the lesser evil in neonatal mortality and can be advised.
Knowledge is power. So, knowing how HIV affects women during pregnancy not only gives the woman enough time to start therapy to prevent long-term problems for herself but also gives her the chance to protect her unborn baby from contracting this infection.