HIV a těhotenství, porod

Profylaxe žen s HIV během těhotenství

• Most studies demonstrated that TMP-SMZ was not associated with hyperbilirubinemia when administered to mothers during pregnancy and breastfeeding.
• No cases of kernicterus were reported in neonates after maternal ingestion of sulfonamides.
• There is mixed evidence linking ingestion of TMP-SMZ and other sulfonamides in early pregnancy to elevated risks of:
• Oral clefts
• Neural tube defects
• Cardiovascular
• Urinary tract abnormalities
• Some sources found that supplementation with folic acid might ameliorate this potential risk
• Existing guidelines recommend that HIV-infected pregnant women receive prophylaxis, but they differ with regards to:
• Stage of disease
• CD4+ T-lymphocyte count
• Prophylaxis during the 1st trimester.
• Existing data indicate that the risk of serious injury to neonates from maternal use of daily TMP-SMZ prophylaxis during pregnancy and breastfeeding is small.
• Given the substantial benefits of TMP-SMZ prophylaxis for HIV-infected women living in resource-limited settings
• This review indicates that:
• It is safe to abide by the WHO guidelines recommending daily TMP-SMZ prophylaxis for HIV-infected pregnant women.