 | HIV in Pregnancy: A Review (UNAIDS, 1999, 67 p.) |
 |  | (introduction...) |
| | EXECUTIVE SUMMARY |
| | INTRODUCTION |
|  | SECTION A : HIV IN PREGNANCY |
| | (introduction...) |
| | Epidemiology of HIV |
| | Susceptibility of women to HIV infection |
| | (introduction...) |
| | 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 |
| | (introduction...) |
| | 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 |
| | (introduction...) |
| | Antiretroviral therapy |
| | Immune therapy |
| | Nutritional interventions |
| | Mode of delivery |
| | Vaginal cleansing |
| | Modification of infant feeding practice |
| | Voluntary HIV counselling and testing in pregnancy |
| | (introduction...) |
| | 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 |
| | (introduction...) |
| | Antenatal care |
| | (introduction...) |
| | 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 |
| | (introduction...) |
| | Universal precautions |
| | Risks of needlestick injuries |
| | (introduction...) |
| | Management of needlestick injuries and other accidental blood exposure |
| | REFERENCES |
Obstetrical management
Antenatal care of the HIV positive pregnant woman will depend on the woman's risk of experiencing an adverse perinatal outcome. To an extent this will be mediated by other obstetric risk factors and antenatal care will need to be tailored to the individual woman. Consideration can be given to the assessment of fetal growth, whether by regular uterine fundal height measurements or, where available, by serial ultrasound assessments.
Invasive diagnostic procedures, such as chorion villus sampling, amniocentesis or cordocentesis should be avoided where possible, due to a possible risk of infection of the fetus302. External cephalic version of a breech fetus may be associated with potential maternal-fetal circulation leaks and the advantages and disadvantages of the procedure should be very carefully considered.
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