ABSTRACT
Background: To study the effect of HIV and duration of ART on term of delivery, newborn birth weight and adverse fetal outcomes.Methods: Prospective comparative study of 40 HIV seropositive pregnant females with varying duration of ART (tenofovir 300 mg + lamivudine 300 mg + efavirenz 600 mg) and HIV seronegative pregnant females attending ANC and delivering in department of obstetrics and gynecology at S. M. S. Medical College, Jaipur, Rajasthan, India.Results: Most HIV seropositive patients were in age group 25 to 30 years and more number were booked in comparison to unbooked. Adverse fetal outcomes were seen more in HIV seropositive patients and they were found to be statistically significant (p=0.029). No relationship could be derived of duration of ART on either the birth weight or term of delivery or adverse fetal outcomes.Conclusions: Maternal HIV infection was significantly found associated with adverse fetal outcome and this was not affected by the use of ART.
ABSTRACT
La colestasis intrahepática del embarazo (CIDE) se caracteriza por prurito en la segunda mitad del embarazo, prurito que no se asocia con otros problemas dermatológicos o sistémicos. El diagnóstico se confirma con la elevación de los niveles maternos de bilirrubina, enzimas hepáticas y ácidos biliares en ayunas. El pronóstico para el feto es serio, pues la CIDE está asociada con pasaje de meconio, partos prematuros y muerte fetal. El tratamiento con tabletas de ácido ursodeoxicólico (UDCA) mejora el prurito, las pruebas de laboratorio y disminuye los resultados fetales adversos. Para la embarazada, la CIDE es relativamente benigna; pero, se ha observado que en el futuro estas mujeres tienen un riesgo mayor de presentar problemas hepatobiliares, cáncer de la mama e hipotiroidismo que las mujeres que no tuvieron esta complicación. Se recomienda un seguimiento prolongado.
Intrahepatic cholestasis of pregnancy (ICP) consists in pruritus that develops in the second half of pregnancy and is not associated with other dermatological or systemic problems. ICP diagnosis is confirmed by increase in maternal serum bilirubin, liver enzymes and fasting biliary acids. ICP is associated with fetal meconium passage, prematurity and fetal death. Treatment with ursodeoxycholic acid (UDCA) improves pruritus, maternal laboratory anomalies and fetal outcomes. ICP has a relative benign maternal course but compared to women without this complication ICP women have increased risk in developing hepatobiliar problems, breast cancer and hypothyroidism. Long-term follow up is recommended.