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预防艾滋病母婴传播(PPTCT):一家三级医疗中心的四年努力

Prevention of Parent to Child Transmission of HIV (PPTCT): An Effort of 4 Years in a Tertiary Centre.

作者信息

Goswami Sebanti, Chakravorty Partha Sarathi

出版信息

J Obstet Gynaecol India. 2011 Aug;61(4):394-8. doi: 10.1007/s13224-011-0056-1. Epub 2011 Sep 23.

Abstract

OBJECTIVE

The aim of this study was to see the fetomaternal outcome of pregnancy in HIV positive mother.

METHODS

This study was conducted in the department of OBGYN Medical College Kolkata from 1st January 2004 to 31st December 2007, a period of 4 years since the establishment of PPTCT centre in our institution. All the pregnant women attending the antenatal clinic for consultation and those coming directly to labour room for delivery (unbooked cases) were counseled for HIV testing, informed consent was obtained and blood samples collected for HIV testing. Babies of HIV positive women delivered were followed up to 18 months for testing.

RESULTS

The no. of women detected positive were 28, 53, 69 and 98 (total 248) in the consecutive years. Therefore the seroprevalence of HIV was 0.41, 0.63, 0.67 and 0.76% in 2004, 2005, 2006 and 2007 respectively. Out of 248 women who were detected positive in the 3 years, only 103 (41.53%) delivered in our institution. 32 (12.90%) underwent MTP. But unfortunately 113 (i.e. 248 - (103 + 32) = 113) were lost to follow up during antenatal care. Out of the 95 live births, only 46 babies have been tested so far out of which only one is reactive, 45 are non reactive.

CONCLUSION

The main obstacle we faced was in following up the mother and the baby. To achieve a high success rate, PPTCT programmes must have well-trained, supportive staff who take great care to ensure confidentiality. They must be backed up by effective HIV testing and counseling programmes and by good quality HIV/AIDS education, which is essential to eliminate myths and misunderstandings among pregnant women, and to counter stigma and discrimination in the wider community.

摘要

目的

本研究旨在观察HIV阳性母亲妊娠的母婴结局。

方法

本研究于2004年1月1日至2007年12月31日在加尔各答医学院妇产科进行,自我们机构的预防母婴传播(PPTCT)中心成立以来为期4年。所有到产前门诊咨询的孕妇以及直接到产房分娩的孕妇(未登记病例)均接受了HIV检测咨询,获得知情同意并采集血样进行HIV检测。对HIV阳性妇女所生婴儿随访至18个月进行检测。

结果

连续几年检测呈阳性的妇女数量分别为28例、53例、69例和98例(共248例)。因此,2004年、2005年、2006年和2007年HIV血清阳性率分别为0.41%、0.63%、0.67%和0.76%。在这3年中检测呈阳性的248名妇女中,只有103名(41.53%)在我们机构分娩。32名(12.90%)接受了人工流产。但不幸的是,113名(即248 - (103 + 32) = 113)在产前护理期间失访。在95例活产中,到目前为止仅对46名婴儿进行了检测,其中只有1名反应性阳性,45名无反应性。

结论

我们面临的主要障碍是对母亲和婴儿的随访。为了取得高成功率,预防母婴传播项目必须有训练有素、提供支持的工作人员,他们要非常注意确保保密性。这些项目必须有有效的HIV检测和咨询项目以及高质量的HIV/艾滋病教育作为后盾,这对于消除孕妇中的误解和错误观念以及应对更广泛社区中的耻辱和歧视至关重要。

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