HIV Mother-to-Child Transmission, Mode of Delivery, and Duration of Rupture of Membranes: Experience in the Current EraReport as inadecuate




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Infectious Diseases in Obstetrics and GynecologyVolume 2012 2012, Article ID 267969, 5 pages

Clinical Study

Department of Obstetrics and Gynecology, University of Toronto, 92 College Street, Toronto, ON, Canada M5G 1L4

Maternal-Fetal Medicine Division, Department of Obstetrics and Gynecology, University of Toronto, Mount Sinai Hospital, University of Toronto, 600 University Avenue, Toronto, ON, Canada M5G 1X5

Division of Infectious Diseases, Department of Pediatrics, University of Toronto, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, Canada M5G 1X8

Division of Infectious Diseases, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, Canada M5G 1X8

Department of Obstetrics and Gynecology, St. Michael’s Hospital, University of Toronto, 30 Bond Street, Toronto, ON, Canada M5B 1W8

Received 23 December 2011; Accepted 24 March 2012

Academic Editor: Deborah Cohan

Copyright © 2012 Siobhan Mark et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To evaluate whether the length of time of rupture of membranes ROM in optimally managed HIV-positive women on highly active antiretroviral therapy HAART with low viral loads VL is predictive of the risk of mother to child transmission MTCT of the human immunodeficiency virus HIV. Study Methods. A retrospective case series of all HIV-positive women who delivered at two academic tertiary centers in Toronto, Canada from January 2000 to November 2010 was completed. Results. Two hundred and ten HIV-positive women with viral loads <1,000 copies-ml delivered during the study period. VL was undetectable <50 copies-mL for the majority of the women 167, 80%, and <1,000 copies-mL for all women. Mode of delivery was vaginal in 107 51% and cesarean in 103 49%. The median length of time of ROM was 0.63 hours range 0 to 77.87 hours for the entire group and 2.56 hours range 0 to 53.90 hours for those who had a vaginal birth. Among women with undetectable VL, 90 54% had a vaginal birth and 77 46% had a cesarean birth. Among the women in this cohort there were no cases of MTCT of HIV. Conclusions. There was no association between duration of ROM or mode of delivery and MTCT in this cohort of 210 virally suppressed HIV-positive pregnant women.





Author: Siobhan Mark, Kellie E. Murphy, Stanley Read, Ari Bitnun, and Mark H. Yudin

Source: https://www.hindawi.com/



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