Pregnancy and HIV

How does HIV affect the course of pregnancy?

It is known that the human immunodeficiency virus (HIV) is the causative agent of AIDS. There are two types of HIV: HIV-1 (most common) and HIV-2. HIV-1 is more insidious, as 20-40% of its carriers subsequently develop AIDS, while in the second type the risk of the disease is 4-10%. On average, the time of development of AIDS from the moment of infection is 10 years.

The researchers managed to isolate the virus from many fluids of the human body: blood, sperm, vaginal secretion of urine, saliva and tear fluid. But so far only cases of infection have been documented through blood, semen, vaginal secretions and breast milk.

Conception

If people with the human immunodeficiency virus have a desire to have a baby, they need to seriously think and consult a doctor. Naturally, this does not mean that all responsibility for the decision should be shifted to specialists. They perform only an advisory role, and the couple, taking into account all possible risks, makes a decision.

Until now, it has not been proven that the presence of HIV infection in a woman affects the worsening of health during pregnancy. Therefore, under certain conditions, conception is still possible.

There is some difference between how conception occurs (and how to minimize the risk of infection of a child), if the carrier is one or the other of the partners.

So, if an HIV-positive woman:

Modern medicine knows methods of conception, in which the risk of HIV transmission to the fetus is minimized. Unfortunately, none of these methods gives 100% guarantee that the baby will not become infected.

If a woman is HIV-positive and a man is HIV-negative, then at the time of conception there is a risk of infection of a man. That this does not happen, a woman should use a set for self-insemination. For this, the partner's sperm is collected in a sterile vessel and fertilized by the woman in the most fertile period, that is, during ovulation.

If the HIV-positive man:

In this case, there is a risk of infection of a woman. The child, through his father's sperm, will not be directly infected, but will get infected from the mother (naturally, if she becomes infected during an unprotected act). To protect a woman, doctors advise planning to conceive in the most fertile days, as well as in those periods when the viral load of a man is not determined.

Another option is possible - cleaning semen from seminal fluid. Thus, the viral load is reduced, and the virus is not detected. Italian doctors using this method carried out the fertilization of 200 women, and none of them became carriers of the human immunodeficiency virus.

Another option - artificial insemination, which uses for fertilization the sperm of another man.

If both spouses are HIV-positive

In this case, the risk of infection of the child is very high. In addition, with unprotected sex, partners can infect each other with various sexually transmitted diseases (they aggravate the course of the disease), as well as other strains of HIV.

Pregnancy

The pregnancy of an HIV-infected woman should be under the strict supervision of specialists. If a woman stops taking antiviral drugs for the period of gestation, there is a risk of rapid recovery of the viral load. And this, in turn, greatly increases the chances of vertical infection of the child. In general, during pregnancy a child can get infected directly in the womb (from the bloodstream through the placenta) or during childbirth. There is information, that the transmission of HIV from mother to fetus occurs in late pregnancy (closer to childbirth). Nevertheless, the virus was also determined in aborted fetuses for a period of 8 weeks. The risk of transmission of a virus to a child from an infected mother is one to seven.

If HIV is first detected already in a pregnant woman, they are provided with comprehensive information about the possible risks and set a choice: to keep pregnancy or not. The very course of pregnancy in an HIV-positive woman is often complicated.

Birth Period

During childbirth, there is a high risk of infection of the infant, as it is exposed to blood and vaginal secretion. Also, the risk of infection increases the presence of a variety of injuries and wounds, which are formed as a result of the birth process or surgical manipulation (cracks, ruptures, application of forceps).

If a woman takes antiviral drugs, it is unlikely she will be advised to have a cesarean section. The fact is that in her case the chances of transmission of the virus to the child in both cases are equal. If therapy is not performed, elect cesarean.

With a natural delivery, a woman is given a drug Zidovudine, which is a good preventive.

Postpartum period

If at the time of conception, pregnancy and childbirth the baby does not become infected with the virus, this does not mean that he does not become infected in the postpartum period. For example, it is established that the virus is transmitted with the mother's breast milk. Therefore, after the birth of the baby the woman is advised to abandon the idea of ??breastfeeding the baby. In addition, the woman is taught the rules of caring for the baby so that it represents the least risk for him. If the mother takes all the necessary precautions, the risk of infecting a newborn decreases tenfold.

What is worth thinking about?

About whether you really want to keep this pregnancy and whether you agree to take such a risk. You should know: if a child is infected in utero or at birth, in 80% of cases by the age of five he will develop AIDS. Will anyone take care of the baby if the mother or both parents are ill? How will they manage?

The decision whether to save the baby, takes only a couple. And the task of specialists, whatever it may be, support and help them in every possible way.

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