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Complications according to mode of delivery among HIV-positive women with CD4 counts < 500.

Watts H, Mofenson L, Whitehouse J, Read J, Stiehm R, Lambert J, Fowler M, Nemo G; Conference on Retroviruses and Opportunistic Infections.

Program Abstr 6th Conf Retrovir Oppor Infect Conf Retrovir Oppor Infect 6th 1999 Chic Ill. 1999 Jan 31-Feb 4; 6th: 196 (abstract no. 684).

National Institutes of Health, Bethesda, MD.

Recent data suggest planned cesarean section (CS) may decrease intrapartum HIV transmission. Objective: To compare the complication rate by delivery mode among a cohort of HIV+ women with CD4 < 500/uL. Methods: Prospectively collected data from delivery through 6 weeks postpartum from PACTG 185 (a trial of HIVIG vs. IgG to prevent perinatal HIV transmission) were assessed to compare complication rates by delivery mode including CS without labor or rupture of membranes (ROM) (CSnolabor); CS after labor or ROM (CSlabor); vaginal delivery with forceps or vacuum (AVD), or spontaneous vaginal delivery (SVD). All CSnolabor were done for obstetrical indications e.g. repeat, placenta previa, breech, or herpes, not specifically to prevent HIV transmission. Results: (Table: see text) Additional complications included 2 cases of pneumonia, both in the CSlabor group and 2 women developed ovarian abscesses after SVD. Peripartum infections occurred among 17 (19.5%) of those with a CD4 < 200/uL and among 54 (16%) with a CD4 >/= 200/uL (p=0.41). Conclusions: Complication rates among the CSnolabor group were higher than expected with planned CS, possibly because of confounding by the indication for CS, such as placenta previa. As CS among HIV+ women for prevention of transmission increases, complications should be monitored and measures to decrease infections such as prophylactic antibiotics evaluated.

Publication Types:
  • Meeting Abstracts
Keywords:
  • Acquired Immunodeficiency Syndrome
  • Cesarean Section
  • Delivery, Obstetric
  • Disease Progression
  • Female
  • HIV Infections
  • HIV Seropositivity
  • Humans
  • Labor, Obstetric
  • Obstetric Labor Complications
  • Postpartum Period
  • Pregnancy
  • complications
  • surgery
Other ID:
  • 20711918
UI: 102195448

From Meeting Abstracts




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