Rincón Franco Sara, Uriel Montserrat, Rodríguez Luis Martín, Romero Infante Ximena Carolina
Faculty of Medicine, Universidad El Bosque Facultad de Medicina, Bogotá, Colombia.
Fetal Medicine Unit, Ecodiagnóstico El Bosque S.A.S, Bogotá, Colombia.
BMJ Case Rep. 2020 Mar 25;13(3):e233426. doi: 10.1136/bcr-2019-233426.
The HIV/AIDS during pregnancy has high morbidity and mortality, without optimal prevention and treatment. The advanced stage cases are found in developing countries due to late detection, but, also in developed countries due to immigration; therefore, the professionals should know the management steps for these patients. The implementation of specific interventions can reduce vertical transmission incidence until 1%-8%. It is presented a case of a pregnant woman with AIDS detected during first hospitalisation, due to a ventilatory failure by opportunistic germs; at the delivery the specific interventions were implemented, being able to eliminate vertical transmission to the newborn. This article explains the four main aspects to be considered for reducing vertical transmission (detection of HIV, viral load levels-CD4 lymphocyte count, way and moment of childbirth and antiretroviral therapy) and shares experiences of the management of an advanced case, in order to help professionals to handle these cases and its complications.
孕期感染艾滋病毒/艾滋病若未得到最佳预防和治疗,发病率和死亡率会很高。由于检测延迟,晚期病例在发展中国家出现,但在发达国家也因移民问题而存在;因此,专业人员应了解这些患者的管理步骤。实施特定干预措施可将垂直传播发生率降低至1% - 8%。本文介绍了一例孕妇,首次住院时因机会性病菌导致呼吸衰竭而被检测出感染艾滋病;分娩时实施了特定干预措施,成功消除了对新生儿的垂直传播。本文解释了降低垂直传播需考虑的四个主要方面(艾滋病毒检测、病毒载量水平 - CD4淋巴细胞计数、分娩方式和时间以及抗逆转录病毒疗法),并分享了一例晚期病例的管理经验,以帮助专业人员处理此类病例及其并发症。