Amniocentesis in HIV Pregnant Women: 16 Years of Experience

Simões, M; Marques, C; Gonçalves, A; Pereira, AP; Correia, J; Castela, J; Guerreiro, C

http://hdl.handle.net/10400.17/1830

Use this identifier to reference this record.

Name:	Description:	Size:	Format:
Inf Dis Obst Gynec 2013.pdf		562.03 KB	Adobe PDF	Download

Send Feedback

Authors

Abstract(s)

The iatrogenic risk of HIV vertical transmission, calculated in initial epidemiologic studies, seemed to counterindicate invasive prenatal diagnosis (PND) procedures. The implementation of highly active antiretroviral therapy (HAART) represented a turning point in PND management, owing to a rapid and effective reduction of maternal viral load (VL). In the present study, we identified cases of vertical transmission in HIV-infected pregnant women who did amniocentesis in the second trimester of pregnancy (n = 27), from 1996 to 2011. We divided our sample into Group A--women under HAART when submitted to amniocentesis (n = 20) and Group B--women without antiretroviral therapy before amniocentesis (n = 7). We had 1 case of vertical transmission in Group B. Preconceptional or early first trimester HIV serology is essential to avoid performing an amniocentesis without antiretroviral therapy or viral suppression. When there is an indication for amniocentesis in an HIV-infected pregnant woman, it should be done if the patient is on HAART and, if possible, when VL is undetectable. Nowadays, with combined first trimester screening test to select pregnancies with high risk of aneuploidies, advanced maternal age is a less frequent indication to perform PND invasive procedures, representing an outstanding gain in prenatal diagnosis of this population.

Keywords

MAC GIN MAC PED MAC MED MAF Amniocentesis/adverse effects Amniocentesis/methods Amniocentesis/statistics & numerical data Anti-Retroviral Agents Anti-Retroviral Therapy, Highly Active Cohort Studies HIV Infections Iatrogenic Disease Infectious Disease Transmission, Vertical Pregnancy Pregnancy Complications, Infections Pregnancy Trimester, Second