ABSTRACT
OBJECTIVE: to review the literature on antiphospholipid antibodies and their significance to midwifery practice. METHOD: databases using the keywords anticardiolipin antibodies, antiphospholipid antibodies, lupus antibodies, antiphospholipid syndrome, systemic lupus erythematosis, pregnancy loss, pre-eclampsia were searched, 548 articles were generated and 52 were used in the review. FINDINGS: anticardiolipin antibodies are detrimental to successful pregnancy being implicated in failure of implantation, loss of the embryo and the fetus. There is also a risk of prematurity, intrauterine growth retardation and neonatal embolism. The risks to the mother are of pre-eclampsia and embolic complications. If diagnosed and treated early in pregnancy with low-dose aspirin and subcutaneous heparin the outlook for a successful pregnancy is much improved. KEY CONCLUSIONS: much research remains to be undertaken. Researchers need to standardise their criteria so that findings are comparable and larger sample groups are necessary. IMPLICATIONS FOR PRACTICE: antiphospholipid syndrome is an important disorder and a preventable cause of pregnancy loss. Midwives need to encourage women to persevere with therapy to preserve pregnancy and maybe prevent pre-eclampsia or thrombosis. When pregnancies are lost one of the hardest things is when the parents cannot understand why. Midwives need to understand the syndrome to collaborate with doctors in explaining it and supporting grieving parents.
Subject(s)
Antiphospholipid Syndrome , Pregnancy Complications , Pregnancy Outcome , Pregnancy, High-Risk , Anticoagulants/therapeutic use , Antiphospholipid Syndrome/complications , Antiphospholipid Syndrome/diagnosis , Antiphospholipid Syndrome/immunology , Antiphospholipid Syndrome/therapy , Aspirin/therapeutic use , Embolism/etiology , Female , Fetal Death/etiology , Fetal Diseases/etiology , Fetal Growth Retardation/etiology , Heparin/therapeutic use , Humans , Maternal-Child Nursing/methods , Nurse Midwives , Obstetric Labor, Premature/etiology , Pre-Eclampsia/etiology , Pregnancy , Pregnancy Complications/diagnosis , Pregnancy Complications/immunology , Pregnancy Complications/therapy , Pregnancy Outcome/epidemiology , Risk FactorsSubject(s)
Education, Nursing, Continuing/methods , HIV Infections/nursing , HIV Infections/prevention & control , Infection Control Practitioners/psychology , Fear , HIV Infections/transmission , Health Knowledge, Attitudes, Practice , Humans , Infection Control Practitioners/education , Nursing Staff/education , Nursing Staff/psychologyABSTRACT
OBJECTIVE: To review the literature on early vertical transmission of the HIV virus and its possible prevention. METHOD: Databases were searched using the keywords HIV, AIDS, HIV transmission, vertical transmission, HIV pregnancy, HIV newborn, AIDS paediatric, HIV paediatric, HIV maternal, maternal immunity, HIV diagnosis. Two hundred and twenty-nine articles were generated and 41 were used in the review. FINDINGS: Factors which increase the risk of vertical transmission are: maternal drug misuse; maternal infection; malnutrition; and HIV viraemia. There are gaps in knowledge about the mechanisms and rates of transmission indicating further research is needed. KEY CONCLUSIONS: Prevention of early vertical transmission is very important; researchers need to standardise their research criteria when carrying out research so that conclusions are comparable. IMPLICATIONS FOR MIDWIFERY PRACTICE: To promote the health of women and their partners must be educated prior to conception and during pregnancy on family planning and healthy living; HIV positive women need counselling and support, and midwives must consider all unscreened pregnant women to be HIV positive.
