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  • Title: Perioperative morbidity and mortality among human immunodeficiency virus infected women undergoing cesarean delivery.
    Author: Louis J, Landon MB, Gersnoviez RJ, Leveno KJ, Spong CY, Rouse DJ, Moawad AH, Varner MW, Caritis SN, Harper M, Wapner RJ, Miodovnik M, Carpenter M, Peaceman AM, O'Sullivan MJ, Sibai BM, Langer O, Thorp JM, Ramin SM, Mercer BM, Maternal-Fetal Medicine Units Network, National Institute of Child Health and Human Development.
    Journal: Obstet Gynecol; 2007 Aug; 110(2 Pt 1):385-90. PubMed ID: 17666615.
    Abstract:
    OBJECTIVE: To determine whether human immunodeficiency virus (HIV)-infected women have a higher rate of postcesarean morbidity and mortality compared with women without HIV infection. METHODS: A secondary analysis was performed of women with singleton gestations undergoing cesarean delivery with known HIV status. Data were collected as part of a prospective 4-year (1999-2002) observational study and analyzed using logistic regression. Women were surveyed for a large number of intraoperative complications, common perioperative morbidities, and uncommon maternal complications. RESULTS: There were 378 HIV-infected and 54,281 uninfected women who met criteria. Patients infected with HIV were more likely to have postpartum endometritis (11.6% compared with 5.8%, P<.001), require a postpartum blood transfusion (4.0% compared with 2.0%, P=.02), develop maternal sepsis (1.1% compared with 0.2%, P<.001), be treated for pneumonia (1.3% compared with 0.3%, P=.001), and to have a maternal death (0.8% compared with 0.1%, P<.001). After controlling for potential confounders, patients with HIV infection were more likely to have one or more postpartum morbidities (odds ratio 1.6, 95% confidence interval 1.2-2.2). CONCLUSION: Women with HIV infection undergoing cesarean delivery are at increased risk for perioperative morbidity and maternal mortality. LEVEL OF EVIDENCE: II.
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