Pregnancy and HIV infection: the chances of having a he althy baby

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

Pregnancy is wonderful moments, these are dreams and dreams, this is real happiness, especially if it is long-awaited. The expectant mother is making plans for how her life will change with the birth of the baby. And in the midst of all this, like a shot at point-blank range, a diagnosis of HIV can strike. The first feeling is panic. Life is collapsing, everything is flying upside down, but you need to find the strength in yourself to stop and think carefully. Pregnancy and HIV is not a death sentence. In addition, you first need to confirm how reliable the diagnosis is.

Better late than late

Indeed, for many women it is incomprehensible why they need to constantly be tested for various infections during pregnancy. After all, they have a happy family, and this definitely cannot happen to them. In fact, pregnancy and HIV very often go hand in hand. It's just that this disease is very insidious, it can be completely invisible for ten to twelve years. Even if there are a couple of seals (lymph nodes) on the neck, this may remainunnoticed. In some cases, a slight increase in temperature, sore throat, vomiting and diarrhea may occur.

In order to identify the disease, special laboratory tests are needed. The program for the protection of motherhood and childhood necessarily includes a thorough examination of the body of the expectant mother. That is why pregnancy and HIV are two concepts that often go together. Perhaps, if not for an interesting situation, the woman would never have gone to the doctor.

Diagnosis

As already mentioned, the only reliable way to diagnose is laboratory tests. When a woman registers for pregnancy, she is sent for tests from the first day. At the same time, it should be noted that they cannot be prescribed forcibly, without the consent of the patient. But this is in your interest, because pregnancy and HIV, occurring in the body at the same time, should not be left without medical supervision.

The most popular diagnostic method is ELISA, which detects antibodies to HIV in the patient's blood serum. PCR allows you to determine the cells of the virus in the blood. Usually, this test is done when HIV is already suspected, in order to make an accurate diagnosis.

If the doctor told you such bad news, you should not panic. HIV and pregnancy can coexist peacefully enough, and you may well give birth to a he althy baby. At the same time, we must not forget that it is vital for you to work closely with your doctor, take tests and follow the recommendations.

Could there be a mistake?

Of course it can! That is why it is necessary to undergo further examination, especially if you are confident in your partner. The fact is that the primary diagnosis is carried out using the already designated ELISA method, which can give both false positive and false negative results. HIV and pregnancy at the same time is a blow to any expectant mother, but we must remember that the results obtained are not completely reliable.

False-negative result may be if the infection occurred recently. That is, a person is already a carrier, but the body has not yet had time to react and develop protection, antibodies, which doctors find. False positives are even more common, especially in pregnant women. The reasons lie in the physiology of this difficult period. Of course, anyone will not be able to sleep when such news arrives, but first of all, you need to weigh how possible such a development of events is, what were the prerequisites for this, and, of course, continue the examination.

The course of pregnancy

HIV and pregnancy can run their course without too much impact on each other. Pregnancy does not hasten the progression of the infection in women who are at an early stage in the development of the disease. According to statistics, the number of pregnancy complications in this case in infected women practically does not exceed that in women without HIV. The only exception is that bacterial pneumonia is slightly more commonly diagnosed.

HIV test forpregnancy is also necessary in order to assess the stage of development of the disease. By the way, if we compare mortality with the immunodeficiency syndrome of those who gave birth and those who refused to give birth (we are talking about abortion after the diagnosis was made), there are practically no differences.

However, as you already understood, the course of pregnancy very much depends on how long the disease develops, what stage it was at the time of conception, and also on the state of the body. The later the stage, the more complications may occur. These can be frequent and severe bleeding, anemia and premature birth, stillbirth, low fetal weight, and postpartum endometritis. Thus, the more severe the disease, the less likely it is to carry and give birth to a he althy child.

Clinical presentation during pregnancy

This moment is especially important for those women who learned about their disease already during the gestation of the fetus. How does HIV proceed during pregnancy, what are the symptoms and treatment of this disease in expectant mothers? These are questions the answers to which could help many women assess what is happening to them and take appropriate action. But, unfortunately, it is difficult to describe them more or less accurately. The fact is that the immunodeficiency virus develops and progresses against the background of a weakening of the protective functions of the body. And the more the immune system recedes under its onslaught, the more pronounced the symptoms will be.

Usually 6-8 weeks after infection, a person begins to experience the first signs that the expectant mother can easily take for a typical pregnancypicture. Fatigue, fever and reduced performance, as well as diarrhea, may occur during this time.

What is the main difficulty? This stage does not last long - only two weeks, and the symptoms subside. Now the disease takes a latent form. The virus enters the persistence stage. The period can be very long, ranging from two to 10 years. Moreover, if we talk about women, then it is they who have a tendency to a long-term latent stage, in men it is shorter and does not exceed 5 years.

During this period, all lymph nodes increase. This is a suspicious symptom that requires examination. However, here lies the second difficulty: swollen lymph nodes during pregnancy are normal, and very common in he althy people. However, this symptom should definitely alert the expectant mother. It is better to be safe once again than to lose precious time.

Intrauterine development of crumbs

In this matter, doctors were very interested in one point, namely, at what time does infection occur. A lot of information for this was given by the tissues of spontaneous miscarriages and infected mothers. Thus, it was found that the virus is capable of causing intrauterine infection as early as the first trimester, but the likelihood of this is not too high. In this case, children are born with the most severe lesions. As a rule, they do not live long.

More than half of all infections occur in the third trimester, the period immediately before childbirth andactual childbirth.

It is also interesting that until quite recently, the detection of antibodies to HIV in the blood of a pregnant woman was an indication for an immediate termination of pregnancy. This is associated with a high risk of fetal infection. However, today the situation has changed. Thanks to modern treatment, a woman is not sent even for a planned cesarean if she receives the necessary treatment.

Probability of baby being infected

As we know, according to statistics, the immunodeficiency virus is transmitted from mother to child. This is one of the three routes of infection. HIV positive during pregnancy increases the risk of having a child with congenital immunodeficiency virus by 17-50%. However, antiviral treatment reduces the chance of perinatal transmission to 2%. However, when prescribing therapy, it is necessary to take into account the course of pregnancy. HIV, as we have already described, can also be different. Factors that increase the likelihood of passing it on to the fetus are:

• late treatment when the disease has reached an advanced stage;
• infection during pregnancy;
• complicated pregnancy and difficult delivery;
• damage to the skin of the fetus during childbirth.

Infection during childbirth

In fact, if you test positive for HIV during pregnancy, you may very well give birth to a he althy baby. But he will be born with the mother's antibodies. This means that immediately after birth, the child will also be HIV-positive. But for now, this only means that his body does not have its own antibodies, but only maternal ones. It will take another 1-2 years until they completely disappearfrom the body of the crumbs, and now it will be possible to say for sure whether the infection of the child has occurred.

Expectant mother should know that HIV during pregnancy can be transmitted to the baby during fetal development. However, the higher the mother's immunity, the better the placenta works, that is, the organ that protects the fetus from viruses and bacteria in the mother's blood. If the placenta is inflamed or damaged, then the likelihood of infection increases. This is another reason why you need to have a thorough examination by your doctor.

But most often the infection occurs during childbirth. Therefore, pregnancy with HIV infection should be accompanied by mandatory antiviral therapy in order to minimize this likelihood. The fact is that during the passage through the birth canal, the baby has a great chance of coming into contact with blood, which dramatically increases the possibility of infection. If you remember from the school course, this is the shortest way to transmit the virus. A caesarean section is recommended when a large number of viruses are found in the blood.

After childbirth

As we have already said, an HIV test during pregnancy is necessary so that, in case of a positive result, the mother can undergo full therapy and maintain her he alth. During pregnancy, physiological suppression of the immune system occurs. So while the previous study only looked at the pregnancy period, others went further and found that the development of HIV can accelerate after childbirth. Within twosubsequent years, the disease can go into a much more severe stage. Therefore, one cannot rely only on the desire to become a mother. Consultation with a doctor is required at the planning stage. Only this approach can become your assistant. HIV positive during pregnancy can seriously undermine he alth, which will subsequently lead to a reduction in the quality of life.

Breastfeeding and its dangers

Pregnancy with HIV can go very well when the baby develops normally and is born completely he althy. Of course, his blood will contain mother's antibodies, but they may not affect children's immunity. However, now the mother is faced with the choice of whether to breastfeed the baby. The doctor must explain that breastfeeding almost doubles the risk of infection. Therefore, discard it, which will be the best choice. Quality formulas will give your baby a much better future.

Your risks

There are a number of factors that may not play in your favor. This is primarily a weakening of the mother's immunity. A high viral load, that is, a large number of viruses in a woman's blood, is also a bad sign. In this case, the doctor may suggest terminating the pregnancy. We have already talked about breastfeeding - 2/3 of all cases of infection of a child from his mother occur during the first six weeks of life. Multiple pregnancy is also a risk factor.

First of all, the expectant mother needs to be registered as early as possible. Necessarilyfollow all the recommendations of your doctor, then you will have a better chance of giving birth to a he althy baby. Starting from the 14th week, a pregnant woman can take the antiviral drug Azidothymidine or its analogue. She receives such preventive maintenance absolutely free of charge. If a woman for a number of reasons did not take it until the 34th week, then it is necessary to start doing this at a later date. However, the earlier treatment is started, the less likely a mother is to pass the disease on to her baby.

Treatment

HIV therapy during pregnancy requires a careful weighing of the mother's condition and gestational age. That is why leave it to an experienced doctor and in no case try to self-medicate. If you turned to a specialist before pregnancy, at the time of its planning, then most likely you will be prescribed a combination therapy. The decision to start it is made on the basis of two tests - this is the level of CD-4 cells and viral load. Modern treatment requires the simultaneous use of two or more antiviral drugs.

HIV test (pregnancy is the reason to cancel combination therapy) is the starting analysis on which all further treatment is based. Only one antiviral drug is left for the expectant mother in order to prevent infection of the crumbs.

If a woman took combination therapy before pregnancy, then in the event of the onset of such, she is advised to take a break for the first trimester. At the same time, blood for HIV during pregnancy is taken, as a rule, three times, and in a particular case, the number of samples can be increased at the discretiondoctor. The rest of the treatment is symptomatic. This reduces the risk of malformations of the unborn baby, as well as avoiding a formidable state of resistance, in which the virus is no longer amenable to treatment.

What a woman should remember

Despite the fact that the achievements of modern medicine can reduce the risk of infection of a child from his own mother to 2%, it still exists. Therefore, you need to weigh the pros and cons, because a woman, even being HIV-infected, wants to endure and give birth to a he althy baby. The difficulty lies in the fact that you will not know whether your baby was born HIV-positive for a long time, and it is impossible to predict this in advance. So you have a long and tedious wait. An ELISA will give a positive result for about 6 months after birth, so be patient.

When deciding to give birth, a woman should know what awaits her child if he falls into this unfortunate 2%. We remind you that such a minimal probability of having a baby with an immunodeficiency virus is possible only if the woman did not follow all the recommendations of doctors, did not undergo constant examinations and did not take drugs exactly according to the scheme.

HIV is most severe in those babies who were infected in utero. Symptoms in this case are much more pronounced, and often such children do not live to be one year old. A smaller number manage to meet adolescence, but it is possible to predict their life in adulthood only hypothetically,because so far there have been no such cases.

Infection with HIV during childbirth or breastfeeding is somewhat easier, because the virus is already on the formed body with a developing immune system. However, the lifespan of the child will be very limited. Usually, doctors do not make a forecast beyond 20 years.

Prevention

Congenital HIV infection is hospitals and medicines since childhood. Of course, everything must be done to prevent such a development of events. Therefore, it is very important to carry out timely prevention of this disease. Today this work is carried out in three directions. First of all, it is the prevention of HIV among women of childbearing age. The second direction is the prevention of unwanted pregnancies among women with HIV. Finally, the last is the prevention of the transmission of infection from a woman to her child.

A positive HIV pregnancy test isn't the end of the world. However, a woman should be aware that she has a chance to infect a baby. Modern therapy has greatly increased the life expectancy of an HIV-positive person. Many live 20 or more years from the time of infection. However, if for an adult this is a whole life, then for a child it is a chance to meet youth and leave. The achievements of doctors do not relieve women of responsibility, so first of all, each of them should think about the future of their baby.

Instead of a conclusion

This is a topic that can be talked about indefinitely, and still there will be a lot of understatement. An HIV diagnosis, like a bad dream, destroys all plans for the future, but it is especially tragic to find out about your diagnosis during pregnancy. In this case, the expectant mother faces a difficult choice and a colossal responsibility. Give up your baby or give birth? Will he be he althy or will he face endless treatment? All these questions do not have a clear answer. Today we gave you a brief digression, told about the main problems associated with the course of pregnancy in infected women.

Of course, the achievements of modern medicine have made it possible for a huge number of women to feel the joy of motherhood. Today, people diagnosed with HIV believe that they are full members of society, have the right to a family and the birth of he althy children.