Pregnancy And Baby Care Conditions During Pregnancy HIV In Pregnancy

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With the advent of modern medication and certain treatment options, a woman who has HIV can get pregnant and carry her baby to full term, without passing the disease on to her unborn child. While women who are suffering from this disease now have renewed hope of motherhood and a family life, it is important to bear in mind that HIV in pregnancy is not free of complications. Therefore, before planning a baby, HIV positive women should learn about the potential risks that may arise and speak to their doctors about ways to prevent any problems.

There are two ways in which a mother can pass on HIV to her baby during pregnancy. These ways include:

• Sharing blood supply: During pregnancy, the mother's blood also circulates within the unborn baby. This sharing of blood could expose the fetus to the disease, causing the baby to be born with HIV.
• Exposure to the infection during childbirth: During a natural delivery, a baby is exposed to a large amount of the mother's bodily fluids. If the baby is exposed to infected fluids for a long period of time the disease can be transmitted from the mother to the child.

There are certain factors that could increase the risks of HIV transmission from the mother to the child. These include:

• Malnutrition
• Substance abuse
• Smoking and drinking alcohol
• Deficiency of Vitamin A 

Without the proper medication and precautions the risks of passing HIV to a baby is around 25% or so. However, this risk can be reduced to 2% or 3% by following these guidelines:

• Consulting a team of specialists: Women with HIV should make sure that their pregnancy is managed by a multi-disciplinary team, consisting of an HIV physician, an obstetrician, an OBS/ GYN or midwife and a pediatrician.
• Using HIV medication: All people suffering from HIV are required to take medication as prescribed by a doctor. HIV positive women should take a regimen of Zidovudine during pregnancy and during delivery. Babies born to HIV positive moms are also given this medication after delivery, to reduce the risks of transmission.
• Going in for a C Section: Exposure to infected bodily fluids can be minimized with the help of a cesarean delivery. However, it is not necessary for all women who have HIV in pregnancy to go in for a C-section. At times, doctors may consider a vaginal delivery a safer option.

Women who are suffering from HIV should not nurse their babies, as the infection can be transmitted through breast milk.

There is no evidence to show that pregnancy is dangerous for women suffering from HIV.

However, certain HIV drugs should be strictly avoided during pregnancy, because of the harmful effect they can have on an unborn baby. Therefore, it is important to check with a doctor about the medicines that should be taken and avoided during pregnancy.

Causes for HIV during pregnancy

In general, there are four ways in which a person can get infected by HIV. The causes for HIV include:

• Sexual intercourse: HIV can be passed on from one person to another through anal, oral, or vaginal sex. The infections spreads when there is a transfer of bodily fluids, which could include blood, semen or vaginal secretion. Through mouth sores and tears that develop in vagina or rectum during sexual activities, the virus can enter a person's body.
• Blood transfusions: The blood of an infected person can cause the disease to spread to others.
• Needles and syringes: People can contract HIV by using syringes and needles that are contaminated with infected blood. Those who use and share syringes without medical supervision could get the disease from others.
• Mother to child: Women who are HIV positive can pass the infection on to their babies through pregnancy, childbirth or breastfeeding.

HIV tests have now been made a part of prenatal tests.

Symptoms of HIV in pregnancy

The symptoms of HIV may vary, depending upon the stage the infection has progressed to. Within a month or two of exposure to the virus, people usually develop a flu-like illness, which seems to last for weeks. Some of the earlier HIV symptoms in pregnancy include:

• Shortness of breath
• Mild fever
• Cough
• Pain in the joints
• Ulcers in the mouth or around the genital area
• Headaches
• Muscle soreness 
• Rash

The symptoms of HIV may go unnoticed if they are mild. However, if the virus keeps multiplying and destroying the immune cells, the patient may develop chronic symptoms, like:

• Weight loss
• Recurring fever
• Fatigue
• Swollen lymph nodes
• Diarrhea

There is no evidence to show that the symptoms of HIV get any worse during pregnancy.

Tests for HIV in pregnancy

Women who are planning to get pregnant or suspect that they may be pregnant should undergo an HIV test as early as possible. Most doctors also advise the women's partners get tested for HIV. A blood test is conducted to check for the presence of HIV.

Additional information about HIV tests in pregnancy can be obtained from:

• The National AIDS Hotline at 1-800-342-AIDS
• CDC Info at 1-800-232-4636
• National IV Testing Resources