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AIDS. 1995 Aug;9(8):913-7.

The incidence of complications after caesarean section in 156 HIV-positive women.

Author information

1
Department of Obstetrics and Gynaecology, San Paolo Biomedical Institute, Milan, Italy.

Abstract

OBJECTIVE:

To investigate the risks of post-operative complications in HIV-positive mothers who undergo a caesarean section (CS) because the delivery cannot be safely accomplished by the vaginal route or to protect the infant from viral infection.

DESIGN:

In a multicentre study, we reviewed the incidence and type of post-operative complications in 156 HIV-positive women who underwent a CS. These results were compared with those observed in an equal number of HIV-uninfected women who matched for the indication requiring a caesarean delivery, the stage of labour, the integrity or rupture of membranes, and the use of antibiotic prophylaxis.

SETTING:

Seven teaching hospitals providing obstetrical care for mothers infected with HIV.

RESULTS:

We found that six HIV-infected mothers suffered a major complication (two cases of pneumonia, one pleural effusion, two severe anaemia and one sepsis) compared with only one HIV-negative woman who required blood transfusion after surgery. Minor complications like post-operative fever, endometritis, wound and urinary tract infections were significantly more frequent in HIV-positive women than controls. Multivariate analysis revealed that in HIV-infected women the only factor associated with a significant increase in the rate of complications was a CD4 lymphocyte count < 200 x 10(6)/l.

CONCLUSIONS:

The results of our study indicate that HIV-positive mothers are at an increased risk of post-operative complications when delivered by CS. The risk of post-operative complications is higher in HIV-infected women who are severely immunodepressed.

PMID:
7576327
[Indexed for MEDLINE]

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