OBSESTRIC AND PERINATAL OUTCOMES OF PRETERM LABOR IN WOMEN LIVING WITH HIV

Abstract

The objective of the present study is to reveal characteristics of the course of gestation and perinatal outcomes of preterm, labor associated with human immunodeficiency viral infection. Materials and methods. Retrospective case control study with the participation of 76 pregnant HIV-positive women with preterm labor (main group) and their 76 newborns was held. Comparison group consisted of 198 pregnant women without HIV-infection and their 198 newborns. HIV-infection verification was conducted in accordance with the standard procedure regulated by the Order of the Ministry of Health of the Russian Federation. Results. Antenatal chemoprophylaxis with antiretroviral drugs was used in 92,1% of infected patients. In the vast majority of cases (89,4%) the therapy was conducted with the combination of drugs: Combivir (zidovudine 300 mg + lamivudine 150 mg) taken 1 tablet twice daily combined with Kaletra (lopinavir 200 mg + ritonavir 25 mg) taken 2 tablets twice daily. Initiation of ART vary depending on the HIV infection date: in the first trimester of pregnancy, 48,9% of pregnant were intended to treat, in the second trimester — 36,2%, in the third — 6,4%. 7,9 patients did not receive treatment. Intranatal chemoprophylaxis of prevention of mother-to-child transmission was held in 69 (90,8%) HIV-infected patients. HIV-infection was detected in 2 (2,6%) newborns from mothers who did not receive etiotropic treatment. Common complications of gestation under HIV-infection include anemia (61,8%) and intrauterine growth retardation (34,2%), during labor — meconium in the amniotic fluid (31,6%). Respiratory distress syndrome occurred in 6 (7,6%) newborns, cerebral ischemia was diagnosed in 86,8% of newborns, respiratory distress — in 7,9%. Respiratory distress prophylaxis was conducted in 46% cases only. Conclusion. The course of gestation in women living with HIV with preterm labor was complicated by iron-deficiency anemia, intrauterine growth retardation, meconium in the amniotic fluid; cerebral ischaemia and respiratory distress syndrome most commonly occurred in newborns.