In order to take any of
the possible precautions to prevent mother to child transmission,
both the mother and her doctor need to know about the HIV-infection.
Therefore an HIV-test is the first step.
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If an HIV-positive
woman is planning to have a baby, she should talk it over
very thoroughly with her doctor. Many factors must be
taken into consideration, including the woman's general
health, her t-cell count, the viral load
in her blood, and also her general personal circumstances.
After consultation, about 1/3 of couples considering pregnancy
where the woman has HIV, decide not to have a baby. |
During pregnancy, the health of the mother and child must
be carefully monitored. The risk of the antiretroviral drugs
to the child must be carefully balanced against the use of
these drugs in preventing the mother to child transmission
of the virus.
Normally, a mother with HIV will be treated with
antiretroviral drugs, at least in the last three months
of the pregnancy. If before the pregnancy, she hadn't
been undergoing HIV-therapy, and if her state of health
permits, many doctors will wait until the 32nd week.
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If the mother is already taking antiretroviral drugs but
is in a stable and good condition doctors may consider pausing
the therapy during the first three months of the pregnancy
(until organ building of the foetus is completed).
Since the viral load (i.e. the number of viruses in
the mother's blood) is a good indicator of the probability
of virus transmission from mother to child during pregnancy,
it is normally observed thoroughly. During delivery the drug
AZT will usually be given intravenously to the mother.
A planned caesarean section prior to the water breaking
can prevent the child from being exposed to maternal blood
and secretions and this can significantly reduce the risk
of transmission during delivery.
The newborn child will normally be treated with AZT directly
after birth and for the first four to six weeks of his or
her life. Since the virus can be transmitted through the mother's
milk, doctors would recommend that the mum does not breast-feed
her baby.
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