OBSTETRIC PROBLEMS IN HIV-INFECTED WOMEN

Abstract

Objective: to study the features of the course of pregnancy and childbirth in HIV-infected women in the Saratov region according to a retrospective analysis of case histories for 2013–2018. Materials and methods. A retrospective clinical and statistical analysis of the course of pregnancy, childbirth and the postnatal period was carried out according to medical records of 282 HIV-infected pregnant women who were treated at the State Agrarian Medical Center (Engels, Saratov Region, Russia) in 2013–2018. (main group). The comparison group consisted of patients who were not infected with HIV who were treated at the SAUS EOC in 2013–2018. To assess the statistical significance of differences, the standard statistical analysis software package STATISTICA 10,0 was used. Results. Compared to 2013, in 2018, the age of HIV-infected pregnant women has decreased (p<0,05). HIV-infected people are less likely to go to a maternity clinic before the 12th week of pregnancy (p<0,05). A high frequency of co-infection of HIV-infected women with urinary infection (p<0,05) and genital tract (p<0,05), hepatitis C viruses (p<0,05) and B (p<0,05), and syphilis was found anamnesis (p<0,05). A high susceptibility of these women to viral infections was noted: acute respiratory viral infection (p<0,05), genital herpes virus (p<0,05), cytomegalovirus infection (p<0,05). The incidence of sexually transmitted infections is high: urogenital chlamydia (p <0,05), trichomonas colpitis (p<0,05). HIV-infected pregnant women have an increased incidence of anemia (p<0,05), chronic pyelonephritis (p<0,05), and skin diseases (p<0,05), and body mass deficiency is more common (p<0,05). In case of HIV infection, the frequency of operative delivery (p<0,05), premature birth (p<0,05), the frequency of formation of a low-weight fetus at a time of gestation (p<0,05), as well as perinatal mortality (p<0,05). The reserve for reducing perinatal mortality for newborns from HIV-infected mothers is in the pregravid period, testing for HIV, hepatitis C virus, correction of the patient’s weight, elimination of the iron deficiency condition, detection and rehabilitation of urogenital foci. When taking to a dispensary account, control and correction of anemia, chronic infectious diseases, monitoring of the state of the vaginal biocenosis are necessary, in the second half of pregnancy — control of fetal growth.