Human immunodeficiency virus infection in pregnancy

Prerequsite result of routine human immunodeficiency virus serology among infertile women before assisted reproduction technology

Background:

Sexually transmitted diseases such as Human Immunodeficiency Virus (HIV) which causes or induces incurable fatal infections have been transmitted through Assisted Reproduction Technology and from infected mothers to the fetus or new born.

Aim:

The aim of this study is to determine the prevalence of this chronic viral agent among infertile women recruited for Assisted Reproduction Technique programme in Benin City, Nigeria.

Materials and Method:

Sera (serum) from Five hundred and Ninety infertile women attending Human Reproduction Research Programme/In-vitro fertilization Center at University of Benin Teaching Hospital were screened for the presence of Human Immunodeficiency Virus antibody using three algorithm or techniques of Determine, Unigold and Stat Pack kits. The age range of the infertile women was 20-49 years.

Result:

28 (4.7%) out of Five Hundred and fifty infertile women recruited for Assisted Reproduction Technique and screened for Human Immunodeficiency Virus antibody were seropositive with increase in prevalence of 10. 0%, 8.5% and 7.5% among infertile women in age groups of (20 – 24), (25 – 29)yrs and (30 – 34)yrs. Chi-square statistical analysis of data shows insignificance in seroprevalence rate in relation to the number of infertile women screened (P > 0.0001) but the screening of these infertile women for the presence Human Immunodeficiency Virus should continue due to the attendant effects.

Conclusion:

Infertile women who are Human Immunodeficiency Virus carriers give a new dimension to assisted reproductive techniques. This will no doubt help to prevent further spread and adverse pregnancy outcome.

HIV infection in critically ill obstetrical patients

OBJECTIVES

The effect of HIV-infection on the clinical course of critically ill obstetrical patients by means of a case-control study was evaluated.

METHODS

Over one calendar year 440 patients were admitted to a high risk obstetrical unit. All patients were tested for HIV-infection. HIV-positive patients were included in the study group and two HIV-negative patients for every HIV-positive patient were included in the control group.

RESULTS

No differences were found between the two groups regarding demographic data, diagnosis, antibiotic use, mode of delivery, duration of hospital stay and mortality. More complications occurred in the HIV-negative group. Eclampsia recorded for the HIV-negative group was 17.1% and 4.7% for the HIV-positive group (P=0.04; 95% CI: -17.1%; -0.9%) and lung edema was 18.2% and 6.2%, respectively (P=0.01; 95% CI: -19.3%; -3.5%). The median CD4/CD8 ratio was significantly lower in the HIV-positive group (0.43) than the HIV-negative group (1.37) (P<0.01; 95% CI: -1.04; -0.79).

CONCLUSIONS

HIV-infection did not significantly alter the clinical course of critically ill patients in an obstetrical high care unit.

Risk assessment

Risk assessment is the process by which clinicians screen for conditions that, if unmanaged, result in complications of pregnancy or adverse birth outcomes and for which an intervention would improve the well-being of the mother, child, and family. One of the major US health care goals is that by the year 2000, at least 90% of pregnant women will receive risk appropriate care. This article discusses the major risks to the mother and child during pregnancy, and presents tools to assess pregnancy well-being.