Pregnancy and AIDS.

Abstract

Since the first cases of a new acquired immunodeficiency syndrome (AIDS) described by Oleske et al. and Rubinstein et al. in children in 1983, we have witnessed an ever-increasing number of such observations. As serology is not being performed on all pregnant women in many European countries, obstetricians must try to identify those belonging to risk groups: intravenous drug abusers, natives of affected regions or women having travelled to these areas, women having numerous sexual partners, presenting with other sexually transmitted diseases or living with infected individuals, prostitutes, transfused women. If the woman belongs to risk groups, HIV antibody testing is to be done at the beginning of pregnancy. The risks for the mother remain ill-defined, due in part to the difficulties inherent in keeping track of heroin abusers. Aggravation is certain if the mother is affected with AIDS or an associated syndrome called ARC (AIDS-related complex). It is debatable and at least rarer if the mother presents no clinical symptoms. Infant risks are becoming better known. The existence of materno-fetal contamination by transplacental route is undebatable. However, contamination during delivery or during the passage through the maternal genital tract cannot be excluded. The proportion of contaminated infants is approximately 40%. The disease in the infant is highly dangerous. According to these data, the procedure adopted by most obstetricians is the following: abortion is recommended at the first trimester of the pregnancy, a free choice is left open for the woman at the second trimester and at the third trimester delivery is carried out naturally. Caesarean sections are only done when there are obstetrical indications.(ABSTRACT TRUNCATED AT 250 WORDS)