October 24, 2002
Researchers in the United States and the United Kingdom have found that pregnant HIV patients taking antiretroviral medication can safely undergo cesarean section with spinal anesthesia. "Elective cesarean section decreases the likelihood of vertical human immunodeficiency virus transmission from mother to infant," explained Michael S. Avidan and colleagues at Washington University School of Medicine in St. Louis, and the King's College Hospital and Chelsea and Westminster Hospital National Health Service Trusts in London.
Avidan and coauthors found that cesarean section delivery with anesthesia poses little risk to new mothers taking powerful antiretroviral medications. The researchers compared hemodynamic stability and morbidity risk for HIV-positive and healthy women during and after cesarean section delivery. All of the study participants received spinal anesthesia, according to the report "Low Complication Rate Associated with Cesarean Section Under Spinal Anesthesia for HIV-1-Infected Women on Antiretroviral Therapy," published in Anesthesiology (2002;97:320-324).
HIV-positive women showed hemodynamic stability comparable with healthy women during delivery. Postoperative infections also developed at comparable rates in both cohorts. HIV-positive women showed a transient rise in CD4 cell counts immediately after delivery, while HIV RNA levels remained at baseline levels. "Elective cesarean section under spinal anesthesia for women infected with HIV-1 taking antiretroviral therapy was not associated with intraoperative or postoperative complications," Avidan and colleagues concluded.
Women's Health Weekly
10.24.02; Michael Greer