Unfortunately, in recent years, HIV infections are widely spread. However, despite the fact that HIV infection treatment is still susceptible only partially, the lifespan of the sick person is sufficiently high - up to 15 - 20 years. And so it is not surprising that many HIV-infected women a desire to have a baby, especially if they still do not have children.
Some condemn this desire of female patients, some support. However, the fact remains, no matter how it is treated around - the birth of a child is the choice of a woman who wants to leave behind a trail. And that's her choice - her right, because only a woman can take responsibility for the life and health of her child. However, many HIV-infected women does not stop - HIV and pregnancy go hand in hand is not so rare as it might seem at first glance. And in some cases, the woman decides to give birth to an HIV-infected man.
However, the expectant mother in any case should not forget that pregnancy in HIV infection is radically different from all the others. The birth of a healthy baby is quite possible, however, for this expectant mother will have to exert a lot of effort. But that just does not go for the health of the mother of his child? This is what will be discussed below.
Conceiving a child from an HIV-positive couple
Caring for the health of the child must start from the beginning - from conception. Proper Conception, would greatly reduce the risk of infection of the baby. The fact that the baby can be infected with HIV during pregnancy, childbirth or breastfeeding, it is known to all. But few know that it is impossible infected child from the father, who has HIV infection, as the virus does not enter the sperm. And the egg and sperm are completely sterile - they do not contain anything other than the nutrients needed for the development of the embryo and the genetic information of parents.
But this is only one side of the coin. It is known that spermatozoa are biological fluid - in the seed, wherein the immunodeficiency virus concentration is highest. This means that an infected man with a very high degree of probability can transmit the virus to a healthy woman. And even if a woman is not scary, it must necessarily bear in mind that it is, in turn, can infect the future remains.
And even if you are infected with both partners engage in unprotected sex for the purpose of pregnancy is also extremely dangerous. Once in the human immunodeficiency virus mutates. And during unprotected sex partners are infected each other again, each of the variety of the virus. Furthermore, in such a situation, the risk of transmission from mother to child, why risk it still not worth it.
It is in order to avoid these complications, modern medicine offers several alternative methods of conception for couples where one or both partners are HIV-positive. These methods include:
- A couple in which the woman is infected
In the case of HIV-infected woman in the pair, the most optimal and safest option is artificial insemination (not to be confused with artificial insemination). During the period of ovulation - approximately 13 - 14 days of the menstrual cycle during release of a mature egg from the ovary, the woman's vagina, the doctor inserts into a woman's vagina preassembled semen.
- A couple in which the man is infected
In that case, if the pair is infected male physicians offer several options. The least frequently used sexual contact, which is not protected by a condom. To do this with the help of a couple of doctors must carefully plan the time of ovulation - when the egg came from the ovary and is ready for insemination. The day should be set precisely in order to maximize the chances of fertilization, as each repeated unprotected sexual intercourse at times increases the risk of infection by women.
Before such a way fertilization sexual partners should be carefully evaluated for the presence of certain diseases and the need to treat them. In addition, doctors will conduct a special therapy that times will reduce the risk of infection of women - it is a very important measure of preconception.
The second method of conception in this situation - a cleansing and direct injection of sperm into the vagina at a certain day of the menstrual cycle when the egg is ready for fertilization. A similar method of fertilization is by far one of the safest for the woman and the unborn child, so doctors recommend couples in which the husband is infected with HIV, it is the method of conception.
So everything turned out the couple and the woman is pregnant. Then it begins not less important for the health of the future baby period - just the pregnancy itself. Expectant mother should as soon as possible contact the nearest AIDS - center. Experts of the center will appoint the expectant mother all the necessary research, a woman will put on the account, will be given a number of drugs that help reduce the risk of HIV transmission from mother to child.
In addition to the surveillance of AIDS - the center of the expectant mother must as soon as possible to register for pregnancy. Of course, during the first visit you have to tell your doctor - a gynecologist about their disease, but remember that your doctor - this is the main your ally in the fight for the health of the child. So try to build a good relationship with your doctor. Do not take a hostile reception to these or other issues, or a doctor's advice - get one thing: no one will blame you, and all the questions the doctor asks only to help you and your child.
As a rule, the physician guides the future mother on a number of standard pregnancy tests. These include general analysis of blood and urine to determine the level of sugar in the blood, ultrasound. However, apart from this survey of HIV-infected expectant mother is usually necessary to take a blood test that will determine the viral load and immune status of the pregnant woman. These studies are essential - on the basis of their doctor will be able to evaluate not only the behavior of the virus and the immune status of the state, but also to understand what the overall health of the future mother. Based on these data, the doctor can determine the future strategy of antiretroviral therapy.
In addition, if the pregnancy was not planned, and the woman has not passed a full investigation of the body before conception, her doctor would prescribe tests that will show whether there is a future mother of the disease, sexually transmitted diseases, blood tests for hepatitis. In addition, the doctor will swab to determine the vaginal microflora.
A woman in any case should not ignore the regular visits to the doctor - a gynecologist and strict compliance with all its requirements. Otherwise there is a risk of premature birth. A premature birth greatly increase the likelihood of infecting the baby with HIV.
Medical treatments during pregnancy
Most of the doctors - gynecologists and virologists rightly believe that HIV-positive pregnant women should be possible to protect against all kinds of medical procedures. Of course, we are talking about those procedures that are somehow connected with the violation of the integrity of skin and mucous membranes, and especially with the invasion of the uterine lining. All these activities greatly increase the risk of HIV transmission from mother to fetus.
As a rule, all such treatments are usually given to pregnant women for diagnosis of certain malformations and genetic disorders in the fetus. And if in the case of a normal pregnancy, such studies almost completely safe for both the mother and for the unborn baby, the HIV-infected woman during such procedures is very much at risk. Therefore, in the case of a woman, there are some - or fear, she should consult a genetics before pregnancy.
However, if HIV-infected pregnant women will appoint such procedures, it has every right to ask your doctor to explain what has caused such a need, it is possible to replace these procedures by other methods of research, such as ultrasound, which requires no penetration into the uterus.
In the same case, if for one reason or another to abandon such procedures there is no way a pregnant woman should see to it that the doctor is mandatory before the intervention appointed viral load test, with the help of which is determined by level of virus in the blood. You also need to conduct additional course of antiretroviral therapy, which can help significantly reduce the probability of infection of the child.
What to pay attention to?
There are several key points that HIV-infected women should pay special attention. The main points are opportunistic infections.
For pregnant women with HIV infection represents a serious threat to any disease. However, the most desirable so-called opportunistic infections, which are typical of immunodeficiency and are nothing more than a measure of disease progression. Below are described methods for preventing such infections:
Too many pets are often the source of infection. Even if the animal appears healthy, it may be the carrier of various pathogenic bacteria and viruses. Therefore, if a future HIV-infected mothers have pets, it must entrust their care to your family and regularly inspect the animal by a veterinarian.
- Environment and nutrition expectant mother
Expectant mother must be very careful with water. First, in any case not allowed to use tap water - only boiled or bottled. Secondly, during pregnancy should avoid swimming in natural bodies of water, because there can be quite a large number of microbes.
It is equally important to avoid contact of the pregnant woman with the soil, avoid contact with farm animals, such as cows, sheep and goats. It is equally important to give up raw dairy products and eggs. All products must be purchased only in specially designated places, avoiding disaster markets.
- Regular visits to doctors
It is very important for HIV-infected expectant mother in a timely manner and regularly observed in all the necessary expertise. Which experts - in each case is decided individually depending on what is available comorbidities. But AIDS experts - center and a doctor - a gynecologist in this list are strictly necessary. As a rule, in the normal course of pregnancy in the first half of its the woman should attend the above-mentioned experts twice a month, and after that, as often as is deemed necessary by doctors.
In that case, if the pregnancy proceeds normally, the future mother is hospitalized in a maternity hospital for about two weeks before the expected date of delivery. In the same case, if there are any - any abnormalities during pregnancy, hospitalization may be made at any stage when the physician deems it necessary. Refusing hospitalization in any case unacceptable - in fact in the presence of HIV risk for various complications increases significantly.
Peculiarities of HIV as a result of the impact of pregnancy
It has long been scientifically proven by the fact that during pregnancy is always a significant reduction of the immune system - is necessary in order to the woman's body does not reject the fetus. And it is quite natural that HIV-infected women worry about how pregnancy will affect her already weakened virus to the immune system. Many believe that it is a natural change of the immune system can accelerate the progression of HIV infection and worsen the disease.
However, numerous and lengthy observation of the course of the disease in HIV-infected pregnant women indicate that there is no disease progression during the childbearing are observed. Moreover - inexplicable, but the fact - more than half of the immune system of women after pregnancy has improved significantly. But, of course, only under the condition that the expectant mother receives all necessary treatment.
Also, one can not ignore such a sensitive issue as the methods and the probability of infection of the child. In that case, if a pregnant woman does not take any preventive measures, the likelihood that the child will be infected is about 40 - 50%. There are several ways of HIV transmission from mother to child - during pregnancy, childbirth, and even during breastfeeding.
- Infection during pregnancy
In some cases the virus from the blood the mother through the placenta to the fetus can penetrate. Normally, the placenta should protect the crumbs from a variety contained in the mother's blood pathogens, including HIV. However, if for some - reason placenta is damaged, or involved in the inflammatory process, its protective function is greatly reduced, and can penetrate the HIV from the mother to the fetus.
- Infection during childbirth
There are two ways of infecting the baby during childbirth. Firstly, during the passage of a child birth canal may receive the virus if its skin or mucous membranes are small abrasions or sores. Or the child may pass during childbirth swallow vaginal secretions and blood of an infected mother. And through the mucosa of the stomach and intestines of HIV can get into the blood of the child.
- Infection during breastfeeding
In the case of breast-feeding the baby can become infected either directly through breast milk and through the blood in the case, if there are cracks in the mother's nipples. The risk of infecting the baby during breastfeeding is about 40%. Therefore, doctors often offer immediately after the birth of a child to transfer to artificial feeding. It's much safer than breastfeeding in this case.
Risk factors for infection kid
Doctors divide the factors that have a significant impact on the risk of infecting the baby with HIV, into three main groups:
One of the most important factors is the viral load of the parent body. The higher a woman's indicators of flu activity, the higher the child's risk of infection with human immunodeficiency virus. Another important factor - the immune status of women. The lower the blood levels in pregnant women of immune cells, the greater the probability that the child is also infected.
In addition, the important role played by lifestyle, HIV infected pregnant women. For example, all the harmful habits such as smoking, drinking alcoholic beverages, largely impairs the immune system, which means that the risk of transmission of human immunodeficiency virus as a child increases significantly. Furthermore, it is adversely affected by the presence of different female genital infections. In order to reduce the risk of transmission of HIV from mother to child, doctors use a special anti-retroviral therapy.
There are also certain gynecological factors. One of the first of these factors is premature effusion of amniotic fluid. In case free period is more than three hours, the risk of the child becoming infected with human immunodeficiency virus is increased by about 40%. And then each subsequent hour dry period increases the risk of transmission by ten percent.
From the physiological characteristics of the child also depends on the risk of transmission of HIV. For example, the very important role played by the weight of a newborn baby - the lower weight baby, the greater the chance that the virus can enter the body of the child. This is not surprising - in the event that a child light weight (less than 2500g), he does not have a well-developed immune system and the protective reaction of the mucous membranes and skin and is still very weak.