Introduction: Women diagnosed with HIV/AIDS may transmit the infection to their child during pregnancy, childbirth, or breastfeeding. However, the risk of mother-to-child transmission of HIV may be reduced by the use of antiretroviral therapy (ART).
Objective: The main aim of the study is to appreciate the declining trend of HIV in babies with HIV positive mother by implementation of PPTCT services.
Methodology: A retrospective study of detection of HIV positive mothers among all the antenatal patients attending OPD and including the patients coming in Emergency services and delivered at Mahila chikitsalaya, SMS Medical College, Jaipur from July 2008 to Dec 2017 was included in the study. They were screened for HIV status and further management of all HIV positive patients.
Results: Total 220445 patients have attended OPD over 10 years from 2008 to 2017 among which total 150077 patients have tested for HIV (68.07%). Among these 240(0.15%) patients were found HIV reactive. From history, we could elicit sexual contact as a prime mode of infection in these women 198(82.50%), followed by blood transfusion in 31 (12.91%), and through needle injury/sharing in 11(4.58%). The CD4 count was more than 200 in 86% women. In total 240 patients 3 patients were aborted that were excluded. Out of 237 HIV-infected women, 35.02% (83) had a cesarean delivery and vaginal delivery was primary mode of delivery in 154(67.94%). HIV-infected women were more likely to have preterm, IUGR and anemia (16.45, 8.86%, 6.4%). There were no maternal mortality. Mean age of HIV positive women was 24.62±3.6 years. Mean parity was 1.72±0.48. In total 237 deliveries, 60(25.31%) babies were low birth weight. Mean birth weight was 2354.60±499g. Among total 154 vaginal deliveries, only 2 (1.29%) babies were found HIV ELISA positive at 18 months and in 83 LSCS, only 2 babies (2.40%) were found HIV positive. Among 237 deliveries, 229 babies (96.62%) were alive and rest 8 babies (3.37%) were still birth. In total 229 alive babies, 25 babies were admitted in NICU and early neonatal mortality occurs in 8 babies, and late neonatal mortality occurs in 6 babies. Among total alive 229 babies, 160(69.86%) babies were on breastfeed and 69(30.13%) babies were on top feed.
Conclusion: Good antenatal care and multidisciplinary team approach can optimize pregnancy outcomes in HIV-infected women.