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 Mode of delivery and HIV vertical transmission  



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Author12 Posts
  #1

I came across a question in NMS regarding this and the answer given there was that mode of delivery has no impact on vertical transmission.Considering the fact the major route of fetal infection is contact with infected genital secretions at vaginal delivery(with transplacental infection being a close second) I am wondering if this actually holds true.I know C-S is currently offered as an option to all HIV + women.....so there has to be more to this.What do you guys think?




  #2

cs reduces the risk of hiv transmission to newborn and hence shd be offered to all hiv positive women


  #3

What is vertical transmission?
Placental transmission and through breast milk only?
or will it include even direct fluid contact during vaginal delivery?



  #4

I THINK THAT VERTICAL IS IN THE UTERO AND AROUND DELIVERY.

and not containe brest feeding?????



  #5

Vertical transmission: Passage of a disease-causing agent (a pathogen) vertically from mother directly to baby during the perinatal period, the period immediately before and after birth. The perinatal period is defined in diverse ways. Depending on the definition, it starts at the 20th to 28th week of gestation and ends 1 to 4 weeks after birth. A vertically transmitted pathogen might, for example, be HIV (the human immunodeficiency virus). Transmission might occur across the placenta or in the breast milk. Also called perinatal transmission.



  #6

Data available in good sources clearly state that CS + antiretroviral therapy reduce vertical transmission. Though I didn't find a statement about the role of CS ALONE on vertical transmission, given the above statement, it seems an absurd thing to say that the mode of delivery has no impact on the vertical transmission of HIV. Currently it is practised, based on studies, and you should go with the current studies.

In medicine, what has been proven once has been disproven later. Some statements stand undisputed and some, corrected. The excellent method of proving and disproving that medicine uses, namely epidemiology, is not foolproof. Still, the best one can do is go with the most established statements.



  #7

AZT treatment antepartum and post partum decreses vertical transm from 25% - 8% in vaginal delivery and CS decreases 2% more


  #8

this is a confusing thing..

in kaplan medicine ...it is said that c section in only indicated in hiv positive pt if her cd4 count and viral load are not controlled by antireteroviral therapy...so not always done

but in kaplan gynaecology lectures.( video lectures)...it is clearly said that C section is Offered to all patients and than the decision is left on mother..and it is best to have c section...

but i think that i would go for c section...!!



  #9

CS


  #10

I think antepartum, intrapartum zidovudine, c/s to mother, zdv immediately to newborn after delivery is ideal.If mother insists on vaginal route u should opt to it.


  #11

agree with pavi...


  #12

www.sogc.org/guidelines/pub...%20mode%20of%20delivery%22

page 3--conclusion and page 1 recommendations ..
  • [left]not enough evidence available to recommend an elective scheduled Caesarean section for patients receiving adequate multiple therapy and with significant viral load reduction.[/left]






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