Balsdon M J
Servicio de Obstetricia y Ginecología, Hospital Barros Luco-Trudeau, Santiago.
Rev Chil Obstet Ginecol. 1994;59(6):476-84.
HIV infection is increasingly affecting the practice of obstetrics and gynaecology. Gynaecological problems include an increased risk of sexually transmitted diseases and other genital infections in HIV positive women. Also cervical neoplasia is more common, more severe and progresses more rapidly. The risk of infection to the surgeon during surgical procedures on HIV positive women can be minimized by simple universal precautions. Pregnancy does not affect the course of HIV infection and neither is routine management of antenatal care altered by the infection. However, routine testing of all pregnant women for HIV would enable reduction of the risk of vertical transmission of HIV to the fetus (in Chile about 25%). Levels of vertical transmission could be reduced substantially by using zidovudine in pregnancy (and in the neonate), by cesarean section before active labour and by not breast feeding.
艾滋病毒感染对妇产科医疗实践的影响日益增大。妇科问题包括艾滋病毒阳性女性感染性传播疾病及其他生殖器感染的风险增加。此外,宫颈肿瘤更为常见、病情更严重且进展更快。通过简单的通用预防措施,可将在艾滋病毒阳性女性身上进行外科手术时外科医生的感染风险降至最低。怀孕并不影响艾滋病毒感染进程,感染也不会改变产前护理的常规管理。然而,对所有孕妇进行艾滋病毒常规检测可降低艾滋病毒垂直传播给胎儿的风险(在智利约为25%)。通过孕期(及新生儿期)使用齐多夫定、在活跃分娩前进行剖宫产以及不进行母乳喂养,可大幅降低垂直传播水平。