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
- 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.