DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20174441

Obstetric outcome of phase IV of National AIDS Control Programme at a tertiary care centre

Vijay Y. Kalyankar, Bhakti V. Kalyankar, Shriniwas N. Gadappa, Ummehani G. Rasool

Abstract


Background: This study was conducted to observe maternal and fetal outcome of sero-positive women delivering at our centre by using the newly introduced National AIDS Control Programme (NACP) phase IV of HARRT (highly active antiretroviral therapy) recommended by National AIDS Control Organisation (GOI) started from 1st January 2014.

Methods: Study included all seropositive pregnant women diagnosed during pregnancy and in emergency at labour room of Government Medical College, Aurangabad, Maharashtra, India in 2 years period. The women and their newborns were managed as per recommendations of phase IV of National AIDS Control Programme of Government of India.

Results: There was reduction in associated maternal infections, high CD4 counts, increase in vaginal deliveries, promotion of exclusive breast feeding and limitation of vertical transmission of HIV. The adverse impact of HIV on mother and newborn still continues.

Conclusions: Phase IV of NACP appears to be promising in the initial phases of its implementation.


Keywords


NACO, Phase IV of NACP, Sero positive pregnant women

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References


National Control Organization (NACO). HIV Sentinel Surveillance and HIV Estimation in India 2007. Available at http://www.nacoonline.org/upload/Publication/M&E%20.

UNAIDS. Asia:AIDS epidemic summary regional summary. 2008. Available at http://data.unaids.org/pub/Report/2008/jc1527_epibriefs_asia_en_pdf.

National Aids Control Organization. Revised national PPTCT guidelines by NACO. 2014.

Turner BJ, Newschaffer CJ, Cocroft J, Fanning TR, Marcus S, Hauck WW. Improved birth outcomes among HIV-infected women with enhanced Medicaid prenatal care. Am J Public Health. 2000;90(1):85.

Joshi U, Patel S, Shah K, Oza U, Modi U. Studying PPTCT services, interventions, coverage and utilization in India. J Glob Infect Dis. 2011;3(4):371-7.

Goswami S, Chakravorty PS. Prevention of Parent to Child Transmission of HIV (PPTCT). An effort of 4 years in a Tertiary Centre. J Obstet Gynaecol India. 2011;61(4):394-8.

Gupta RS, Hegde A. Descriptive study of the utility of individual tracking tool in program monitoring for prevention of mother to child transmission of HIV, Maharashtra, India. Curr Opin HIV AIDS. 2016;11(1):30.

Monreal MT, Cunha RV, Trinca LA. Compliance to antiretroviral medication as reported by AIDS patients assisted at the University Hospital of the Federal University of Mato Grosso do Sul. Br J Infect Dis. 2002;6(1):08-14.

Townsend C. Antiretroviral therapy and pregnancy outcome in HIV infected women in the United Kingdom and Ireland. University College, London. 2009.

Townsend C, Schulte J, Thorne C, Dominguez KI, Tookey PA, Cortina-Borja M, et al. Antiretroviral therapy and preterm delivery: a pooled analysis of data from the United States and Europe. BJOG. 2010;117(11):1399-410.

Mayaux MJ, Dussaix E, Ispoet J, Rekacewicz C, Mandelbrot L, Vigneron CN, et al. Maternal viral load during pregnancy and mother to child transmission of human immunodeficiency virus type 1. The French Perinatal Cohort Studies. J Infect Dis 1997;175:172-5.

Thea DM, Steketee RW, Pliner V, Bornschlegel K, Brown T, Orloff S, et al. The effect of maternal viral load on the risk of perinatal transmission of HIV-1. New York City Perinatal HIV Transmission Collaborative Study Group. 1997;11(4):437-44.

Leroy V, Ladner J, Nyiraziraje M, De Clercq A, Bazubagira A, Van de Perre P, et al. Pregnancy and HIV Study Group. Effect of HIV‐1 infection on pregnancy outcome in women in Kigali, Rwanda, 1992-1994. AIDS. 1998;12(6):643-50.

Kennedy D. The effect of maternal HIV status on perinatal outcome at Mowbray Maternity Hospital and referring midwife obstetric units, Capetown. SAJOG. 2012;18(1):7-10.

Kim HY, Kasonde P, Mwiya M, Thea DM, Kankasa C, Sinkala M, et al. Pregnancy loss and role of infant HIV status on perinatal mortality among HIV infected women. BMC Pediatr. 2012;12:138.

Kind C, Rudin C, Siegrist CA, Wyler CA, Biedermann K, Lauper U, et al. Prevention of vertical HIV transmission: additive protective effect of elective cesarean section and Zidovudine prophylaxis. Swiss Neonatal HIV Study Group. AIDS. 1998;12(2):205-10.

Azria E. Pregnancy outcomes in women with HIV type-1 receiving a lopinavir/ritonavir containing regimen. Int Med Press. 2009:1359-6535.

Musana JW. Pregnancy outcomes in mothers with advanced human immunodeficiency virus disease. East Afr Med J. 2009;86(10):480-5.

Ezechi OC. Pregnancy, obstetric and neonatal outcomes in HIV positive Nigerian women. Afr J Reproductive Health. 2013;17(3):160-8.

Coley JL. The association between maternal HIV-1 infection and pregnancy outcomes in Dar es Salaam, Tanzania. BJOG. 2001;108:1125-33.

Alger, Lindsay S, Farley, John J, Robinson, Barbara A, et al. Interactions of Human Immunodeficiency virus infections and pregnancy. Obstet Gynecol. 1993;82(5):787-96.