Objective Increasing numbers of HIV-positive women are delivering in the UK, and thanks to several large studies, guidelines have been successfully implemented for managing this group of patients. This study was aimed at assessing the level of adherence to local and national guidelines, by clinicians, and the success rates of these measures, at the James Paget Hospital (JPH).
Methods Cases of HIV-positive pregnant women, who booked and delivered at the JPH from January 1997 to January 2008, were selected. The following outcomes were assessed with regard to the women: HIV type and time diagnosed; viral load and CD4 counts; antiretroviral therapy (ART); delivery (mode, complications, outcome, ART etc). Outcomes for infants were as follows: birth details; post-exposure prophylaxis; feeding options; HIV status.
Results There were a total of thirteen deliveries by twelve women within the 11-year period. There were twelve live births and one stillbirth, which occurred as a result of drug toxicity (nevirapine). Most women had HIV-1 subtype and were on at least one type of ART. Most women delivered via caesarean section, although 50% of these were emergency cases due to premature onset of labour. All neonates received adequate ART from delivery for at least 4 weeks, and there were no reported cases of HIV infection.
Conclusion There is good adherence to local and national guidelines, with good success rates. However, more guidance is needed with respect to ART prescribing in pregnant women, as well as more overall detailed JPH guidelines for these women.