HIV and Pregnancy - Research Paper Example

Transmission occurs through body fluids like blood, semen, cervical or vaginal discharge and breast milk (Reynolds, 2004). Vertical transmission is thereby possible during pregnancy, labor and breast-feeding period. The gravity of the problem is indicated by the statistics which tell us that 15-20% of infants born to HIV positive women not on retro-viral treatment will be infected during the last trimester of pregnancy and more so in labor. This paper deals with the methods of managing and preventing this incurable disease being transmitted from mother to child during the pregnancy period, during labor and during the infancy period and the role of nurses in this function.

The HIV has an affinity for the CD4 cells or the T helper lymphocytes which are the key role players in the body immune response (Reynolds, 2004). HIV later develops into AIDS. The symptoms of the illness are actually symptoms of the opportunistic infections, associated tumors and encephalopathy. Children born to HIV positive women may carry the antibodies for one year. They cannot be considered positive till above one year of age. The Department of Health in UK recommends an HIV test for all pregnant women so nobody can claim lack of awareness of their condition (Hawkins et al, 2005).

The ethics of providing treatment for infertility had previously been questioned but now centers are reviewing their policies (Hawkins et al, 2005). Vertical transmission may be facilitated during pregnancy by malnutrition, high viral load in the first trimester, reactivated herpes simplex infection, genital infections and illicit drug use (NAM, 2004). Prevention may be targeted at these focal points to reduce the vertical transmission. Malnutrition may be prevented by ensuring that pregnant women consume sufficient nutritious food, compensating for diarrhea by more potassium-containing foods, nausea by taking small frequent meals and loss of weight by nutritional supplements (Reynolds, 2004).

Mouth ulcers and candidiasis may be corrected similarly. Avoiding infection and providing timely and apt treatment would help in controlling infection. However this becomes a problem if other children are in the family. Regular blood tests like CD cell count and other tests could indicate the immune response status. Exposure to blood-borne infections like herpes simplex and cytomegalus viruses and toxoplasmosis must be noted as they could be activated again when the immunity reduces. Prophylaxis is possible by instituting anti-retroviral therapy when the CD4 count lowers from 250cells/cu.mm. Prognosis is facilitated by the three-drug HAART therapy of nevirapine, lamivudine and zidovudine (AVERT, 2002).

These are avoided in the first 14 weeks as they could produce terratogenesis. Problems like drug resistance and side-effects like nausea, vomiting and diarrhea are expected. Opportunistic infections may be treated but they too produce similar side-effects and thrombocytopenia. Support may be provided to those who use illicit drugs and wean them away. The women may be given oral zidovudine in the last 26 weeks of pregnancy and intravenous zidovudine (AZT) during labor and oral AZT syrup for the infant for the first six weeks when breastfeeding is avoided (Reynolds, 2004).

Bloodless Caesarian Sections could be planned for delivery. Invasive procedures need to be avoided. A difficult labor should not be permitted to happen. The doctors and staff