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目的:分析妊娠合并人类免疫缺陷病毒(HIV)感染产妇分娩前后情况,以及母婴阻断效果。方法:回顾分析东南大学附属南京市第二医院妇产科2005年3月至2016年10月住院分娩的30例妊娠合并HIV感染患者的临床资料。患者于孕前或孕期采用高效抗逆转录病毒治疗(HAART)。选取同期住院分娩的排除传染性疾病的正常孕妇90例。比较两组的孕期合并症、分娩情况、分娩方式及新生儿情况。监测研究组的阻断效果及新生儿生长发育情况。结果:研究组和对照组的孕期贫血、羊水过少、羊水污染发生率比较,差异均有统计学意义(26.67%vs 13.33%,33.33%vs 15.55%,23.33%vs 6.67%,P<0.05)。研究组的剖宫产率高于对照组,差异有统计学意义(93.33%vs 48.89%,P<0.05)。两组的新生儿体质量比较,差异有统计学意义[(3045.67±341.69)g vs(3273.44±430.19)g,P<0.05];两组的男婴数及1min Apgar评分比较,差异无统计学意义(P>0.05)。截稿为止,随访至18月婴儿无一例感染(3例失访),随访的婴儿生长发育情况与同龄婴儿比较,未发现明显异常。结论:合并HIV感染孕妇分娩前后合并症及并发症发生概率相对较高。孕期运用HARRT方案,择期行剖宫产分娩、新生儿预防性使用抗病毒药物及人工喂养是阻断HIV母婴传播的重要措施。
OBJECTIVE: To analyze the situation of maternal pregnancy with HIV infection before and after childbirth, as well as the effect of maternal and child blockage. Methods: The clinical data of 30 pregnant women with HIV infection who were hospitalized and delivered from March 2005 to October 2016 in Department of Obstetrics and Gynecology of the Second Affiliated Hospital of Nanjing Medical University were retrospectively analyzed. Patients use highly active antiretroviral therapy (HAART) before or during pregnancy. 90 cases of normal pregnant women who were excluded from infectious diseases during the same period of hospital delivery were selected. Comparing the two groups during pregnancy complications, childbirth, mode of delivery and neonatal conditions. Monitoring study group blocking effect and neonatal growth and development. Results: The incidences of anemia, oligohydramnios and amniotic fluid contamination during pregnancy were significantly different between study group and control group (26.67% vs 13.33%, 33.33% vs 15.55%, 23.33% vs 6.67%, P <0.05) . The rate of cesarean section in the study group was higher than that in the control group, with a significant difference (93.33% vs 48.89%, P <0.05). There were significant differences in body weight between the two groups ([(3045.67 ± 341.69) g vs (3273.44 ± 430.19) g, P <0.05]. There was no significant difference in the number of baby boys and Apgar scores Significance (P> 0.05). Until the deadline for follow-up, none of the infants were followed up until 18 months (3 lost), and no significant abnormalities were observed in the growth and development of infants following follow-up. Conclusion: The incidence of complications and complications before and after delivery in pregnant women with HIV infection is relatively high. HARRT program during pregnancy, elective cesarean section delivery, neonatal prophylactic use of antiviral drugs and artificial feeding is an important measure to block the mother-to-child transmission of HIV.