HIV in pregnant women: What you need to know

The article was professionally consulted by Dr. Mang Thi Phuong Mai - Department of Medical Examination & Internal Medicine - Vinmec Nha Trang International General Hospital

HIV infection in pregnant women threatens the health of the mother and the fetus because the HIV virus can be transmitted to the baby through the placenta, during childbirth, or through breast milk after birth.

According to statistics of the Department of HIV/AIDS Prevention and Control under the Ministry of Health, in 2017 there were more than 2.7 million pregnant women nationwide. In which, the number of pregnant women undergoing HIV testing is nearly 1.4 million (accounting for more than 50%), detecting 1,108 people infected with HIV, the HIV-positive rate in the group of early diagnosis within 2 months. postpartum is 1.8%.
A mother infected with HIV can pass it on to her baby through 3 stages:
When the mother is pregnant, HIV from the mother passes through the placenta into the fetus's body very early, possibly as early as the 8th week of pregnancy. About 17-25% of newborns are likely to be infected with HIV at this stage. At birth, HIV is transmitted from the body fluids and blood of an HIV-infected mother into the baby's body. About 50-60% of babies are infected with HIV from this stage. When breastfeeding, HIV can be transmitted through breast milk or cracks and scratches in the nipple to the baby's body. About 15-25% of babies are infected with HIV while breastfeeding.

To screen for HIV in pregnant women, all pregnant women should go to health facilities for HIV examination and counseling as soon as possible (preferably in the first 3 months). If the disease is detected and the drug is taken according to the treatment regimen early, the patient can ensure optimal effectiveness in reducing the rate of mother-to-child transmission.
What pregnant women with HIV need to do to have a healthy pregnancy:
Ensure good health before becoming pregnant. If the patient is HIV-positive and has not been treated with ART, the physician should be consulted about the appropriate time for prophylactic treatment to prevent the possibility of HIV transmission to the child. If you are on ART, you should see your doctor early to discuss medications you can take during pregnancy. Depending on the time of determining HIV-positive at what stage of pregnancy, doctors will have appropriate prophylactic indications and the use of antiretroviral drugs will be carried out according to a separate regimen. During labor, it is necessary to minimize trauma to the mother and baby: ensure absolute aseptic during delivery, do not cut the amniotic membranes early, limit interventions that cause genital bleeding during delivery, and avoid intervention procedures that can cause damage to the baby's skin,... After birth, it is best for the child to be fed formula milk to replace breast milk to avoid the risk of HIV transmission from the mother. Make sure your baby is tested for HIV early at birth or before taking medication. If your baby is diagnosed with HIV, both mother and baby should take prescribed HIV medications.

Note: In addition to medical care, timely mental care and counseling measures also help pregnant women have more knowledge about HIV/AIDS transmission, help them stabilize their psychological well-being and compliance. Follow the guidelines for treatment and prevention well.

In the process of taking care of pregnant women with HIV, doctors and patients' families need to be especially careful. Important notes are:
Let pregnant women use some personal items separately such as: towels, towels, toothbrushes, tongue scrapers, nail clippers, needles,... Wear gloves rubber when taking care of open wounds for pregnant women, avoid direct contact. Instruments such as towels, clothes, ... that have been stained with pregnant women's blood need to be soaked in Javen water (0.1 - 0.5%) for 30 minutes before washing again with soap. If a pregnant woman's towel is contaminated with solid substances such as feces, vomit, ..., it should be pre-washed before soaking Javen, then washed with soap. When contaminated with blood, secretions of pregnant women or accidentally pierced by sharp objects of the patient, caregivers should immediately wash hands with soap and disinfect with alcohol. Besides, after home treatment, relatives of pregnant women with HIV should contact a specialized medical center for guidance on disease prevention. For garbage with the patient's blood such as paper, cotton, needles, bandages, etc., it is necessary to put it in a plastic bag twice, tie it up before putting it in the trash. In addition, relatives of HIV-infected pregnant women should work with sanitation workers to distinguish these medical waste from ordinary waste, avoiding the risk of HIV transmission to others. In addition, caregivers of HIV-infected pregnant women need to keep the patient's psychology stable because psychological trauma can adversely affect the health of both mother and baby.