Guideline on invasive obstetric procedures in the HIV-infected pregnant woman

C N Mnyani; E Nicolaou; E Bera; V Black; J C Hull; J A McIntyre

doi:10.7196/sajog.419

Guideline

Guideline on invasive obstetric procedures in the HIV-infected pregnant woman

C N Mnyani, E Nicolaou, E Bera, V Black, J C Hull, J A McIntyre

Abstract

Antenatal invasive obstetric procedures in HIV-infected pregnant women are associated with a risk of mother-to-child HIV transmission. There are limited published data on the subject. The general consensus is that any HIV-infected pregnant woman who needs to undergo an invasive procedure should have combination antiretroviral therapy initiated prior to the procedure, regardless of the CD4+ cell count. The recommendations in this guideline, developed to assist clinicians in counselling and managing HIV-infected pregnant women in need of an invasive procedure, are based on small observational studies and local experience.

Authors' affiliations

C N Mnyani, Anova Health Institute

E Nicolaou, Maternal Fetal Medicine Centre, Morningside MediClnic, University of the Witwatersrand, Johannesburg; Department of Obstetrics and Gynaecology, Chris Hani Baragwanath Academic Hospital, Johannesburg,

E Bera, Department of Obstetrics and Gynaecology, Rahima Moosa Mother and Child Hospital, University of the Witwatersrand, Johannesburg

V Black, Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg

J C Hull, Department of Obstetrics and Gynaecology, Chris Hani Baragwanath Academic Hospital, Johannesburg

J A McIntyre, Anova Health Institute, Johannesburg; Centre for Infectious Diseases, Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town