• The features of gestation, childbirth and perinatal consequences in HIV-infected women (Retrospective analysis)
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The features of gestation, childbirth and perinatal consequences in HIV-infected women (Retrospective analysis)

HEALTH OF WOMAN. 2018.1(127):102–106; doi 10.15574/HW.2018.127.102

Savchenko S. E., Gervazyuk О. І.
National Medical Academy of Postgraduate Education PL Shupik, Kyiv
Kyiv City Center for Reproductive and Perinatal Medicine

The objective: was to determine the peculiarities of gestation, childbirth and the newborns state in HIV-infected women.
Materials and methods. A retrospective analysis of 1050 medical cards of HIV-positive pregnant women and their newborns and 85 women without HIV during 2012-2015 years was conducted.
Results. CD4+ concentration and viral load indicate effective antiretroviral therapy in most patients. The most often complication of gestation in women with HIV is placental dysfunction. Such a threatening complication as placental abruption was observed in 37 (3.5±0.56%) HIV-infected pregnant women and in 12 (1.4±0.4%) control women. Fetal distress was found in 109 (10.4±0.94%) patients of main group versus 16 (1.9±0.46%) control women (p<0.05). A higher blood loss rate during labour and caesarean section in HIV-infected women with long-term high-level antiretroviral therapy was noted. The maladaptive syndromes in early neonatal period were identified in newborns from HIV-infected women. The decompensation of placental insufficiency with critical circulation disorders plays a significant role among the causes of perinatal mortality in this newborns.
Conclusions. The gestation process in pregnant women with HIV-infection is characterized by the greater frequency of perinatal complications and threatening conditions for both – the mother and the fetus. The current theory about the effects of HIV on the hemostasis system justifies the importance of studying the rheological status and the function of endothelium in HIV-infected pregnant women for timely diagnosis, treatment and prevention of obstetric and perinatal complications.
Key words: HIV-infected pregnant women, pregnancy course, childbirth, mother–placenta–fetal system, perinatal consequences.

REFERENCES

1. Belousova TV i dr. 2016. Vzaimosvyazi v sisteme mat–platsenta–rebenok pri sostoyanii tromboticheskoy gotovnosti i gematogennyih trombofiliyah. Byulleten sibirskoy meditsiny 15;5:5–15.

2. Ilina AYa i dr. 2016. Trombofiliya kak etiopatogeneticheskiy faktor narusheniy v sisteme «zhenschina–plod–novorozhdennyiy». Akusherstvo, ginekologiya i reproduktsiya. 10;4.

3. Інформаційний бюлетень № 46 «Віл-інфекція в Україні» від 2016 р.

4. Pivnik AV i dr. 2008. Trombotsitopeniya pri VICh-infektsii. Terapevticheskiy arhiv 80;7:75–80.

5. Yakushin SS, Filippov EV. 2011. VICh-infektsiya i serdechno-sosudistyie oslozhneniya. Klinitsist 2:6–12.

6. Bibas M, Biava G, Antinori A. 2011. HIV-associated venous thromboembolism. Mediterranean journal of hematology and infectious diseases 3;1. https://doi.org/10.4084/mjhid.2011.030; PMid:21869916 PMCid:PMC3152452

7. Duprez DA et al. 2012. Inflammation, coagulation and cardiovascular disease in HIV-infected individuals. PloS one. 7;9:e44454.

8. Islam FM et al. 2012. Relative risk of cardiovascular disease among people living with HIV: a systematic review and meta‐analysis. HIV medicine 13;8:453–468. https://doi.org/10.1111/j.1468-1293.2012.00996.x

9. Moskaliuk VD et al. 2013. A Shift of the endothelial dysfunction markers in patiens with HIV-infection/AIDS under HAART. Інфекційні хвороби 2.

10. Musselwhite LW et al. 2011. Markers of endothelial dysfunction, coagulation and tissue fibrosis independently predict venous thromboembolism in HIV. AIDS (London, England). 25;6:787.

11. Nicolaides A et al. 2013. Prevention and treatment of venous thromboembolism: international consensus statement (guidelines according to scientific evidence). Clinical and Applied Thrombosis/Hemostasis. 19;2:116–118. https://doi.org/10.1177/1076029612474840; PMid:23529476

12. Rasmussen LD et al. 2011. HIV and risk of venous thromboembolism: a Danish nation wide population based cohort study. HIV medicine 12;4:202–210. https://doi.org/10.1111/j.1468-1293.2010.00869.x; PMid:20726905

13. Scottish Intercollegiate Guidelines Network (SIGN). Prevention and management of venous thrombo-embolism. A national clinical guideline. Edinburgh (Scotland): Scottish Intercollegiate Guidelines Network (SIGN). 2010, Dec.:101. (SIGN publication 122).

14. Simcox LE et al. 2015. Thrombophilia and pregnancy complications. International journal of molecular sciences 16;12:28418–28428. https://doi.org/10.3390/ijms161226104; PMid:26633369 PMCid:PMC4691051