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怀孕与艾滋病。

Pregnancy and AIDS.

作者信息

Henrion R

机构信息

Port-Royal University Clinic, Paris, France.

出版信息

Hum Reprod. 1988 Feb;3(2):257-62. doi: 10.1093/oxfordjournals.humrep.a136689.

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)

摘要

自1983年奥列斯克等人和鲁宾斯坦等人首次描述儿童新型获得性免疫缺陷综合征(艾滋病)病例以来,我们目睹了此类病例数量的不断增加。由于许多欧洲国家并非对所有孕妇进行血清学检测,产科医生必须设法识别属于高危人群的孕妇:静脉注射吸毒者、疫区本地人或前往过这些地区的女性、有多个性伴侣的女性、患有其他性传播疾病或与感染者共同生活的女性、妓女、接受过输血的女性。如果女性属于高危人群,应在妊娠初期进行艾滋病毒抗体检测。母亲面临的风险尚不明确,部分原因在于追踪海洛因滥用者存在固有困难。如果母亲感染了艾滋病或一种名为ARC(艾滋病相关综合征)的相关综合征,病情肯定会加重。如果母亲没有临床症状,情况则存在争议且至少较为罕见。婴儿面临的风险正日益为人所知。经胎盘途径发生母婴传播是毋庸置疑的。然而,不能排除分娩期间或通过母体生殖道时的传播。受感染婴儿的比例约为40%。婴儿感染这种疾病非常危险。根据这些数据,大多数产科医生采取的程序如下:建议在妊娠早期进行人工流产,在妊娠中期让女性自由选择,在妊娠晚期自然分娩。只有在有产科指征时才进行剖宫产。(摘要截选至250字)

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