Needlestick injuries occur relatively commonly in obstetric
practice and health workers should know their local policy for the appropriate
management of injury. The most common form of injury occurs when re-sheathing
needles. Injuries from hollow needles are more dangerous than those from solid
surgical needles, as they are more likely to transfer blood.
Any such injury carries a risk of exposure to HIV, Hepatitis
virus, and other pathogens. For Hepatitis B the risk of infection is between 5%
(HBV-e Ag negative source patient) and 43% (HBV-e Ag positive source patient).
The amount of blood required to transmit Hepatitis B is only 0.00004 ml, while a
minimum of 0.1 ml is required for HIV transmission. All health care workers
should have Hepatitis B vaccinations, in view of the high risk of accidental
transmission, and high prevalence in many developing countries.
Estimates of the risk of HIV transmission from patient to health
care worker vary from 0.23% to 0.5% per exposure384,396,397,398,399.
The type of exposure and the stage of the HIV positive source patient affect the
risk, since the viral load will be greater in the recently infected patient and
in late stages of the disease. The estimated risk of transmission of HIV from a
deep needlestick injury from an HIV-positive patient is 0.4%, and the estimated
risk of transmission from a trans-cutaneous exposure is