 | HIV in Pregnancy: A Review (UNAIDS, 1999, 67 p.) |
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| | EXECUTIVE SUMMARY |
| | INTRODUCTION |
|  | SECTION A : HIV IN PREGNANCY |
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| | Epidemiology of HIV |
| | Susceptibility of women to HIV infection |
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| | Biological factors |
| | Socio-cultural factors |
| | Effect of pregnancy on the natural history of HIV infection |
| | Effect of HIV infection on pregnancy |
| | Mother-to-child transmission |
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| | Factors affecting mother-to-child transmission of HIV-1 |
| | Interventions to prevent mother-to-child transmission of HIV |
| | Appropriate interventions to reduce mother-to-child transmission |
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| | Antiretroviral therapy |
| | Immune therapy |
| | Nutritional interventions |
| | Mode of delivery |
| | Vaginal cleansing |
| | Modification of infant feeding practice |
| | Voluntary HIV counselling and testing in pregnancy |
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| | Testing of antenatal women |
| | Counselling before and after HIV testing in pregnancy |
| | Counselling about pregnancy-related issues |
| | SECTION B : MANAGEMENT OF HIV-POSITIVE PREGNANT WOMEN |
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| | Antenatal care |
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| | Obstetrical management |
| | Examination and investigations |
| | Medical treatment during pregnancy |
| | Antiretroviral therapy |
| | Care during labour and delivery |
| | Postpartum care |
| | Care of neonates |
| | SECTION C : INFECTION CONTROL MEASURES |
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| | Universal precautions |
| | Risks of needlestick injuries |
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| | Management of needlestick injuries and other accidental blood exposure |
| | REFERENCES |
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The management of HIV positive women during pregnancy is multifaceted, combining medical and obstetrical management with counselling and social support. The woman's social and psychological concerns may be as important as her need for medical care. Ideally, a team approach with health workers, counsellors and support groups should be used358,359,360,361,362.
In all cases, the management in pregnancy, including antiretroviral treatment, should be seen as only a part of the continuum of care for the mother and child360,363,364,290. Ongoing care may be undertaken at home, within the primary health care services, at hospitals, or at specialist clinics, depending upon the individual needs and available facilities365. The following discussion highlights some of the management issues for HIV positive pregnant women, and does not provide detailed guidelines. Diagnostic procedures and medical management will be dependent upon the available resources and each country should develop appropriate recommendations for their own situation.
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