HIV Screening and Management During Pregnancy

Introduction

Ensuring early detection and management of HIV during pregnancy is crucial for maternal and fetal health. Adherence to recommended screening protocols significantly reduces the risk of vertical transmission.

Importance of HIV Screening in Pregnant Women

HIV screening during pregnancy is essential in reducing mother-to-child transmission (MTCT). Early identification allows for timely interventions such as antiretroviral therapy (ART), ensuring better neonatal outcomes.

Recommended Screening Protocols

• First Trimester Screening: Universal HIV testing during the first prenatal visit.
• Repeat Testing: For high-risk populations, an additional test in the third trimester is advised.
• Rapid Testing at Delivery: If prenatal screening was missed, immediate testing during labor is recommended.

Management of HIV-Positive Pregnant Women

Antiretroviral Therapy (ART)

Initiation of ART is recommended for all HIV-positive pregnant women, regardless of CD4 count. Early and continuous treatment reduces viral load and prevents MTCT.

Delivery Planning

For women with undetectable viral loads, vaginal delivery is generally safe. In cases of high viral load, cesarean delivery minimizes transmission risks.

Postpartum Care

Breastfeeding guidelines depend on the healthcare setting. In low-resource settings, exclusive breastfeeding with maternal ART is recommended, whereas in high-resource settings, formula feeding is preferred.

Conclusion

Routine HIV screening and appropriate management significantly reduce the risk of mother-to-child transmission. Clinicians should adhere to evidence-based guidelines to ensure optimal maternal and fetal outcomes.