Outcome of pregnancy in HIV-positive women planned for vaginal delivery under effective antiretroviral therapy

Abstract

This retrospective cohort study was conducted at Newham University Hospital, London to investigate maternal outcome of planned vaginal delivery as well as rate of maternal-to-child transmission. Between June 2004 and June 2006, 23 (16%) women of 144 HIV-infected pregnant women opted for planned vaginal delivery. Offer of vaginal delivery was based on maternal HIV RNA count <50 cells/ml around 36 weeks' gestation. All women received antiretroviral therapy. Fifteen (65%) women achieved vaginal delivery. Babies were followed up over 18 months. All babies had antiretroviral prophylaxis. No babies were breast-fed. There was no report of maternal-to-child transmission in any of these babies. Our study suggests that planned vaginal delivery could be safe with antiretroviral therapy in pregnancy, optimal intrapartum care, viral load of <1000 copies/ml at delivery, retroviral prophylaxis for babies and avoidance of breast-feeding.

Keywords:

• Antiretroviral therapy
• HIV
• maternal-to-child transmission
• planned vaginal delivery
• pregnancy

Acknowledgement

The authors are grateful to Dr Susan Liebeschuetz, Consultant Paediatrician with an HIV interest, Newham University Hospital, London, for her valuable opinion and for the amendments on this manuscript.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.