Post-cesarean section morbidity in HIV-positive women.

BACKGROUND

The present work is an audit of post-cesarean section morbidity in HIV-positive women in the tertiary teaching hospital La Fé, Valencia, Spain.

STUDY DESIGN

Retrospective case-control study.

SUBJECTS

Forty-five HIV-positive pregnant women and 90 appropriately matched controls, delivered by cesarean section in the same hospital and managed using a uniform protocol.

MAIN OUTCOME MEASURES

The duration of stay in hospital after cesarean section, the need for postoperative antibiotics and the incidence of major and minor puerperal complications. Baseline characteristics of HIV-positive women were also analyzed in relation to the morbidity after surgery.

STATISTICAL ANALYSIS

Chi-square analysis for categorical data and parametric and non-parametric tests for numerical data, where appropriate.

RESULTS

Most HIV-positive women (86.7%) had a complicated recovery after surgery. A longer duration of stay in hospital (p<0.0005) and a greater incidence of major (p<0.003) and minor (p<0.00001) postoperative complications were observed in the HIV-positive group compared to the control group. HIV-positive women with > or =500 CD4 lymphocytes/mm3 had less post-cesarean section morbidity

CONCLUSIONS

A greater post-cesarean section morbidity was found in HIV-positive women compared to the control women. Immunological status of HIV-positive women may be important in predicting puerperal morbidity after surgery.