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  • Title: Pregnancy and HIV.
    Author: Blaney CL.
    Journal: Netw Res Triangle Park N C; 1994 Feb; 14(3):24-6. PubMed ID: 12287510.
    Abstract:
    As many as 30% of all pregnant women in sub-Saharan Africa face the twin miseries of having AIDS and risking passing the disease on to their babies. More than a million children are currently infected with the virus, and it is likely that this figure will increase 10-fold by the year 2000. The best way to prevent HIV infections in children is to prevent it in their mothers. The best way for the mothers to prevent it is by maintaining a mutually monogamous sexual relationship with an uninfected partner and using condoms. If a woman is already pregnant and infected, counseling is essential so that the woman understands her risks. Many women continue their pregnancies, and between 14 and 39% of the infants become infected. Infection rates increase when the mother is in the later stages of the disease or when the mother has other sexually transmitted diseases. AIDS babies live short miserable lives, and AIDS mothers have great difficulty caring for their children. Good medical care can improve a mother's health and her baby's chances of survival, but good medical care or even good counseling is not available in many countries. In some countries, abortion is offered to AIDS mothers, but other countries have strict abortion laws. Physicians in these countries are considering whether or not to perform induced abortions for health reasons on HIV-infected women. During deliveries, physicians, midwives, and traditional birth attendants should use protective clothing if possible. In villages, midwives are advised to at least wash their hands and to avoid assisting a delivery if they have an open cut or sore. Sterile procedures after the birth and reducing birth complications that require transfusions will also help prevent the transmission of the disease. Breast feeding of babies of mothers with AIDS is recommended in areas where the primary causes of infant death are infectious disease and malnutrition. In other words, where the baby's chances of dying if they are not breast fed are greater than their chances of contracting AIDS from the breast milk. While health care providers are struggling to prevent and minimize the effects of the disease for pregnant women, researchers are trying to develop new ways to prevent its spread in newborns. Experimental AIDS vaccines, administration of anti-HIV immunoglobulin, and treatment with zidovudine (AZT) during pregnancy are being tested, but the high cost of these therapies may make them unavailable in much of the world. Since many pregnant women do not receive prenatal care in developing countries, a promising prevention measure may be to give antibiotics late in the pregnancy or to wash the woman's birth canal with a disinfectant such as vinegar during labor and delivery. All of these treatment possibilities remain to be tested, and, meanwhile, the disease continues its deadly spread from mother to newborn child.
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