Pregnancy care
Managing HIV & Pregnancy Hand in Hand
Pregnancy care for people with HIV, Hepatitis B and Hepatitis C requires special attention and coordination between healthcare providers to ensure the health and well-being of both the mother and the baby. Here's a general pregnancy care plan:
Preconception Counseling
Prior to conception, people with HIV, Hepatitis B and Hepatitis C should receive counselling on the risks associated with HIV transmission during pregnancy and childbirth. Discussions should also cover the importance of consistent antiretroviral therapy (ART) and adherence to medical appointments.
Antiretroviral Therapy (ART
People with HIV, Hepatitis B and Hepatitis C should start or continue on a recommended ART regimen under the guidance of an infectious disease specialist. The choice of ART regimen will depend on the patient’s medical history, CD4 count, viral load, and potential drug interactions with other medications.
Baseline Laboratory Testing
Baseline laboratory tests should be conducted to assess the overall health and the status of their HIV infection. These tests may include CD4 count, complete blood count, renal function tests, and liver function tests.
Regular Prenatal Care
People with HIV, Hepatitis B and Hepatitis C should receive regular prenatal check-ups with an obstetrician experienced in managing HIV-positive pregnancies. Prenatal care visits typically occur monthly in the first and second trimesters, bi-weekly in the third trimester, and weekly closer to the due date.
HIV Monitoring
HIV viral load should be closely monitored throughout the pregnancy to ensure that the viral load remains undetectable. This helps reduce the risk of mother-to-child transmission.
Viral load testing should be done between 32-36 weeks of pregnancy especially to decide on type of prophylaxis for the infant. This is other than the regular viral load testing.
Preventing Mother-to-Child Transmission (PMTCT)
People with HIV, Hepatitis B and Hepatitis C should be educated about measures to prevent mother-to-child transmission of HIV, including adherence to ART, breastfeeding (as advised by healthcare providers), and receiving infant prophylaxis.
Prenatal Vitamins and Nutrition
A well-balanced diet, along with prenatal vitamins (including folic acid), is essential to support the mother’s health and the development of the baby.
Monitoring of Complications
Regular monitoring for potential pregnancy-related complications, such as gestational diabetes and preeclampsia, should be part of the care plan.
Psychosocial Support
Pregnancy can bring about emotional and psychological challenges, especially for HIV-positive individuals. Offering counselling and psychosocial support can help people with HIV, hepatitis B, and hepatitis C navigate these challenges.
Delivery Planning
Delivery planning should involve discussions about the mode of delivery (vaginal vs. cesarean section) based on the patient’s viral load, obstetric history, and other medical factors. Cesarean section may be recommended if the viral load is not well-controlled closer to delivery.
Labor and Delivery
Healthcare providers experienced in managing HIV-positive pregnancies should be present during labor and delivery to ensure proper infection control measures are followed to minimize the risk of transmission.
Postpartum Care
Postpartum care should involve continued ART, close monitoring of the mother’s health, and guidance on infant feeding practices. The baby will also undergo HIV testing to confirm their status.
Breastfeeding
In many cases, breastfeeding is recommended for HIV-positive mothers. There are many advantages that the baby has from breastfeeding. People with HIV, Hepatitis B and Hepatitis C should receive guidance on appropriate infant feeding options.
This plan is generalized and personalized affordable plan will be developed with expert consultations as per your health conditions.
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