Impact of AIDS on neonatal care.

Abstract

A report produced by the Royal College of Obstetricians and Gynecologists in conjunction with the British Pediatric Association and the Royal College of Midwives sets forth clinical guidelines for the management of human immunodeficiency virus (HIV)-positive mothers and their infants. Also included are recommendations for the protection of health workers from infection. Among the practices recommended are the following: 1) the wearing during delivery of a gown ever a plastic apron together with sterile gloves to avoid soiling of the clothes with potentially infective blood amniotic fluid and lochia; 2) the avoidance in deliveries involving HIV-positive women of use of fetal scalp electrodes and fetal blood sampling since they result in an open wound in a contaminated area; 3) pediatricians who perform resuscitation on infants of seropositive mothers should were full protective clothing; 4) oral mucus extraction should be replaced for all infants with mechanical suction or use of bulb syringes; 5) cord blood sampling desirable in high-risk infants should be performed with a disposable funnel; 6) infants should be washed with soap and water in the delivery room to remove any maternal blood and amniotic fluid; 7) mothers wishing to donate to milk banks should be given an HIV antibody test; 8) gloves should be worn by health staff whenever an infant of a seropositive mother is handled; and 9) laboratory procedures should be reviewed to reduce the risk of broken glass equipment. Where feasible these procedures should be followed in all deliveries to avoid the emergence of a 2-tier approach that stigmatizes HIV-infected mothers and infants. Application of the same precautions to all mothers and babies also protects staff from the transmission of other viral diseases such as hepatitis B.