Pregnancy and HIV infection: the chances of having a healthy baby

Pregnancy are wonderful moments, dreams and dreams, this is real happiness, especially if it is long-awaited. The future mother is making plans, how her life will change with the birth of a crumb. And among all this, like a shot at point-blank range, it can hit a diagnosis - HIV. The first feeling is panic. Life is crumbling, everything is flying around, but you need to find the strength to stop and think. Pregnancy and HIV are not a death sentence. In addition, you first need to confirm how reliable the diagnosis is.

Better late than later

Indeed, for many women it is incomprehensible why they need to constantly take tests for various infections during pregnancy. After all, they have a happy family, and this can not exactly happen to them. In fact, pregnancy and HIV very often go hand in hand. Simply this disease is very insidious, it can be completely invisible for ten to twelve years. Even if there are a couple of seals on the neck (lymph nodes), this can go unnoticed. In some cases, the temperature may slightly increase, there may be a sore throat, vomiting and diarrhea.

In order to identify the disease, special laboratory tests are needed. A thorough examination of the future mother's body is necessarily included in the program for the protection of motherhood and childhood. That is why pregnancy and HIV are two concepts that often occur together. Perhaps, if it were not for an interesting situation, the woman would never have consulted a doctor.

Diagnostics

As I've already been told, the only reliable way to diagnose is laboratory research. When a woman becomes registered for pregnancy, she is sent from the first day to the tests. It should be noted that they can not be prescribed forcibly, without the consent of the patient. But this is in your interest, because pregnancy and HIV, which occur in the body at the same time, should not remain without the supervision of a doctor.

The most popular method of diagnosis is ELISA, with the help of which antibodies to HIV are detected in the serum of the patient. PCR allows you to determine the cells of the virus in the blood. Usually this examination is carried out when there is already a suspicion of HIV to accurately diagnose.

If the doctor told you such unpleasant news, you can not panic. HIV and pregnancy can coexist peacefully enough, and you can well give birth to a healthy baby. At the same time, one must not forget that it is vitally important for you to work closely with the attending physician, take tests and follow recommendations.

Can there be an error?

Of course it can! That is why it is necessary to undergo further examination, especially if you are sure of your partner. The fact is that the primary diagnosis is performed using the already indicated ELISA method, which can give both a false positive and a false negative result. HIV and pregnancy at the same time - it's a blow for any future mother, but we must remember that the results are not completely reliable.

A false-negative result can be if the infection occurred quite recently. That is, a person is already a carrier, but the body has not yet had time to respond and develop protection, antibodies, which doctors find. False positive analysis is even more common, especially in pregnant women. The reasons lie in the physiology of this difficult period. Of course, anyone will not be up to sleep when such news arrives, but first of all, it is necessary to weigh, as far as possible this development of events, what the prerequisites for this were, and, of course, continue the survey.

The course of pregnancy

HIV and pregnancy can proceed in their own way, without greatly affecting one another. Pregnancy does not accelerate the progression of infection in women who are at an early stage of disease development. According to statistics, the number of complications of pregnancy in this case in infected women is almost no more than that of women without HIV. The only exception is that bacterial pneumonia is more often diagnosed.

An HIV test for pregnancy is also necessary to assess the stage of the disease. By the way, if you compare the death rate with the immunodeficiency syndrome that gave birth and refused it (we are talking about abortion after the diagnosis), there is practically no difference.

However, as you have already understood, the course of pregnancy depends very much on how long the disease has developed, what stage it was at the time of conception, and also on the state of the organism. The later the stage, the more complications can arise. This can be frequent and severe bleeding, anemia and premature birth, the birth of a dead child, low fetal weight, and postpartum endometritis. Thus, the heavier the disease, the less likely it is to endure and give birth to a healthy child.

Clinical picture 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 develop during pregnancy, the symptoms and treatment of this ailment in expectant mothers are? These are questions, the answers to which could help many women assess what is happening to them and take adequate measures. But, unfortunately, to describe them more or less accurately difficult. The fact is that the virus of immunodeficiency develops and progresses against the background of 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 and for a typical pregnancy picture. At this time, it is possible to increase fatigue, fever and decreased performance, as well as diarrhea.

What is the main difficulty? This stage does not last long - just two weeks, and the symptoms subsided. Now the disease takes a latent form. The virus passes into the stage of persistence. The period can be very long, ranging from two to 10 years. And if we talk about women, then they have a tendency to long-term latency, 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: the increase in lymph nodes during pregnancy is normal, and very often occurs in healthy people. However, this symptom must be sure to alert the future mother. It is better to be reinsured once again than to lose valuable time.

Intrauterine development of crumbs

In this issue, doctors were very interested in one point, namely, at what time the infection occurs. A lot of information for this was provided by the tissues of spontaneous miscarriages and infected mothers. Thus, it was found that the virus is able to cause intrauterine infection in the first trimester, but the likelihood of this is not too high. In this case, children with severe injuries are born. As a rule, they do not live long.

More than half of all cases of infection occur in the third trimester, the period immediately before birth and actually childbirth.

It is also interesting that, just recently, the detection of pregnant antibodies to HIV in the blood was an indication for an immediate abortion. This is associated with a high risk of infection of the fetus. However, today the situation has changed. Due to modern treatment, a woman does not even go to planned cesarean if she receives the necessary treatment.

Probability of infection of the baby

As we know, according to statistics, the virus of immunodeficiency is transmitted from mother to child. This is one of three ways of infection. HIV positive during pregnancy increases the risk of giving birth to a child with a congenital immunodeficiency virus by 17-50%. However, antiviral treatment reduces the likelihood of perinatal transmission of infection 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 transmission to his fetus are:

• Belated treatment when the disease has reached a late stage;
• Infection during pregnancy;
• Complicated pregnancy and heavy labor;
• Damage to the fetal skin during childbirth.

Infection during childbirth

In fact, if the HIV test for pregnancy is positive, you can easily give birth to a healthy baby. But he will be born with the antibodies of the mother. This means that immediately after childbirth the child will also be HIV-positive. But while this only means that there are no antibodies in his body, only maternal ones. It will take another 1-2 years until they completely disappear from the body of the crumbs, and now it will be possible to say exactly if the infection of the child has occurred.

A future mother should know that HIV during pregnancy can be transmitted to a baby even during intrauterine development. However, the higher the immunity of the mother, the better the placenta works, that is, the organ that protects the fetus from viruses and bacteria in the maternal blood. If the placenta is inflamed or damaged, the probability of infection increases. This is another reason why you need to undergo a thorough examination with your doctor.

But most often the infection occurs during childbirth. Therefore, pregnancy with HIV infection should be accompanied by mandatory antiviral therapy to minimize this probability. The fact is that during passage through the birth canal the baby has a great chance to come in contact with the blood, which sharply increases the possibility of infection. If you remember from the school course, this is the shortest path of transmission of the virus. 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 for pregnancy is necessary so that in case of a positive result the mother can undergo full therapy and maintain her health. In pregnancy, physiological suppression of immunity occurs. Therefore, if the previous study considered only the gestation period, others went further and found that after the birth, the development of HIV could accelerate. Over the next two years, the disease can go to a much more difficult stage. Therefore, you can not rely only on the desire to become a mother. Consultation with a doctor is mandatory at the planning stage. Only this approach can become your assistant. HIV positive during pregnancy can seriously undermine health, which in the future will lead to a reduction in the quality of life.

Breastfeeding and its dangers

Pregnancy of HIV-infected can go very well when a baby develops normally and is born completely healthy. Of course, his mother's antibodies will be contained in his blood, but they may not have an effect on children's immunity. However, now the mother has a choice whether to feed the baby with breast milk. The doctor must explain that breastfeeding increases the risk of infection almost twice. So give it up, which will be the best choice. Qualitative mixtures will give the baby a much better chance for the future.

Your risks

There are a number of factors that can not play in your favor. This is primarily a weakening of the immune system of the mother. High viral load, that is, a large number of viruses in the blood of a woman - this is also a bad sign. In this case, the doctor may propose to terminate the pregnancy. About breastfeeding we already said - 2/3 of all cases of infection of the child from his mother occurs during the first six weeks of life. Multiple pregnancy is also a risk factor.

First of all, the future mother needs to be registered as early as possible. Be sure to follow all the recommendations of the attending physician, then you will have more chances to give birth to a healthy child. Starting from the 14th week, the pregnant woman can take the antiviral drug Azidothymidine or its analogue. She gets such prevention for free. If a woman did not take it for a number of reasons before the 34th week, then it is necessary to start doing it at a later date. However, the earlier treatment is begun, the less chance for mother to transmit the disease to her baby.

Treatment

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

The HIV test (pregnancy is the reason to cancel the combination therapy) is the starting analysis, on which all further treatment is built. For the future mother, only one antiviral drug is left to prevent infection of the crumbs.

If a woman took a combination therapy before pregnancy, then in the event of such it is recommended to take a break for the first trimester. In this case, the blood for HIV during pregnancy is taken, as a rule, three times, and in a particular case the number of samples can increase at the doctor's discretion. In other cases, the treatment is symptomatic. This allows you to reduce the risk of malformations of the future baby, as well as to avoid a formidable state of resistance, in which the virus can no longer be treated.

What a woman should remember

Despite the fact that the achievements of modern medicine can reduce the risk of infection of the child from their 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 healthy baby. The difficulty is that you do not know if your baby was born HIV-positive for a long time, and you can not predict it in advance. So you will have a long and tedious wait. ELISA approximately 6 months after childbirth will give a positive result, so have patience.

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

The hardest of all is HIV in those infants who contracted in utero. Symptoms in this case are much more pronounced, and often such babies do not survive to one year. The smaller number manages to meet the adolescent period, but to predict their life in adulthood can only be hypothetical, since so far there have been no such cases.

Infection with HIV during childbirth or breastfeeding is somewhat easier, because the virus already lays on the formed organism with the developing immune system. Nevertheless, the child's life expectancy will be very limited. Usually, doctors do not make a prediction longer than 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 conduct timely prevention of this disease. Today this work is carried out in three directions. First of all, this 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 one is the prevention of the transmission of infection from a woman to her child.

A positive HIV test for pregnancy is not 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 after the infection. However, if for an adult this is a lifetime, then for the child - a chance to meet youth and leave. The achievements of doctors do not relieve women, so first of all each of them should think about the future of his baby.

Instead of concluding

This is a topic about which you can talk endlessly, and still there will be a lot of understatement. The diagnosis of HIV, like a terrible dream, destroys all plans for the future, but it is especially tragic to find out about your diagnosis during pregnancy. In this case, the future mother faces a difficult choice and a colossal responsibility. Give up your baby or give birth? Will he be healthy or will he need endless treatment? All these questions do not have an unambiguous answer. Today we conducted a short excursion for you, talked about the main problems associated with the course of pregnancy in infected women.

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