Clinical characteristics and obstetrical principals at HIV-infected women in Saint Petersburg

Abstract

Objective: to determine the clinical course of HIV infection, pregnancy and delivery in HIV-infected women. Materials and Methods: the analysis of 1483 clinical records of the HIV-infected women, who were delivered in specialized infectious and obstetric department in Clinical infectious diseases hospital named after S.P. Botkin in 2011-2013. Results: Average age of patients - 28,2 ± 1,2 years. Vast majority of women (78,5 %) knew about the diagnosis “HIV-infection” before pregnancy. The sexual way of transmission dominated (67,6 %) among patients with the detected mechanism of HIV-transmission. Full three-step ARV prevention was performed in 82,4 % (1222) cases. The average amount of patients with 4th stage of HIV infection was 49,2 % (730), thus the number of women in labor with the 4th stage of HIV infection increased from 19,4 to 55,6 % in 2011-2013. There is a high percentage of the coinfection of HIV infection and chronic viral hepatitis C or B + C (50,8 %). The most frequent complications of pregnancy and labour at the HIV-infected women are: iron deficiency anemia, chronic placentary insufficiency, eclampsy, premature discharge of amniotic fluid. Every third pregnant has a combination of these pregnancy complications. Frequency of premature birth was 23,5 %. The majority of pregnant women had vaginal labors (67,3 %) Cesarean sections were performed in 32,7 % cases. Conclusion: In St. Petersburg in 2011-2013 significantly increased the number of women with clinically significant manifestations of HIV infection on the 4th stage of secondary diseases. The most frequent clinical manifestations of 4A stage of HIV infection were fungal (candidiasis) lesion of the mucous genitals, mouth and viral (HSV) lesions of the skin and mucous membranes. The major complications of pregnancy in HIV-infected women are anemia and chronic placental insufficiency. Almost one in four pregnancies ends premature birth. Remains high percentage of cesarean sections, including those caused by infectious indications.