Особливості перебігу гестації, пологів та перинатальні наслідки у ВІЛ-інфікованих жінок (Ретроспективний аналіз)

Abstract

The objective: was to determine the peculiarities of gestation, childbirth and the newborns state in HIV-infected women. Materials and methods. A retrospective analysis of 1050 medical cards of HIV-positive pregnant women and their newborns and 85 women without HIV during 2012-2015 years was conducted. Results. CD4+ concentration and viral load indicate effective antiretroviral therapy in most patients. The most often complication of gestation in women with HIV is placental dysfunction. Such a threatening complication as placental abruption was observed in 37 (3.5±0.56%) HIV-infected pregnant women and in 12 (1.4±0.4%) control women. Fetal distress was found in 109 (10.4±0.94%) patients of main group versus 16 (1.9±0.46%) control women (p<0.05). A higher blood loss rate during labour and caesarean section in HIV-infected women with long-term high-level antiretroviral therapy was noted. The maladaptive syndromes in early neonatal period were identified in newborns from HIV-infected women. The decompensation of placental insufficiency with critical circulation disorders plays a significant role among the causes of perinatal mortality in this newborns. Conclusions. The gestation process in pregnant women with HIV-infection is characterized by the greater frequency of perinatal complications and threatening conditions for both - the mother and the fetus. The current theory about the effects of HIV on the hemostasis system justifies the importance of studying the rheological status and the function of endothelium in HIV-infected pregnant women for timely diagnosis, treatment and prevention of obstetric and perinatal complications. Key words: HIV-infected pregnant women, pregnancy course, childbirth, mother–placenta–fetal system, perinatal consequences.