Management of HIV-positive pregnant women: a Singapore experience

Abstract

Introduction: Perinatal transmission remains one of the important causes of the transmission of the human immunodeficiency virus (HIV). Over the years, with better knowledge and awareness of HIV, the perinatal transmission rate has been significantly reduced. We previously reported on the pregnancy outcomes of HIV-positive mothers from 1997 to 2007 in our institution. This paper aims to review standards of care of HIV-positive pregnant women since then. Methods: A retrospective study reviewed 84 HIV-positive women who delivered in a tertiary centre from January 2008 to December 2015. Patient demographics and antenatal, intrapartum, postnatal and immediate neonatal data were analysed.Results: There were a total of 97 deliveries with 98 neonates. 12 women delivered more than once and there was one set of twins. Mean maternal age at diagnosis of HIV was 27.8 years.Of the study population, 63.1% of women were non-Singaporeans. 56 women were known to have HIV on presentation and 90.7% were on antiretroviral therapy during pregnancy. 88.7% of the women received intrapartum intravenous zidovudine, and 93.1% of women with detectable and 58.7% with undetectable viral load underwent Caesarean sections. All neonates were HIV-negative. Conclusion:Having high standards of care for HIV-positive women has successfully reduced our perinatal transmission rate to zero.

Factors Associated With Intrapartum Detectable Viral Load Among Hiv Positive Parturients at Riley Mother and Baby Hospital, Eldoret-Kenya.

“…However, only about one-third adhere to the recommended eMTCT guidelines 12 . To maintain low viral load levels among infected expectant women, the Joint United Nations Programme on HIV/AIDS (UNAIDS) aims at 73% viral suppression 1,2,13 .…”