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participating institutions:
Johns Hopkins University AIDS Service, New York State DOH AIDS Institute, The CORE Center, Cook County Hospital



NEWS AND NEW DEVELOPMENTS



Postoperative Morbidity Associated With Cesarean Delivery Among Human Immunodeficiency Virus-Seropositive Women [Rodriguez, EJ., et al. Am J Obstet Gynec 2001;184:1108]: This is a case control study of 86 HIV-infected women undergoing C-section from 1992 to 2000 at Emory. The control group included 86 HIV-seronegative women matched for age, race, year of delivery, and delivery indications. The HIV-infected group had more minor postoperative complications (66.3% vs. 41.8%), including febrile morbidity (62.8% vs. 42.7%; p = 0.003), but there was no significant difference in the rate of major complications. AZT use was associated with a decrease in maternal morbidity rates. The authors conclude that C-section is safe in HIV-infected women.
Comment: This has been a somewhat controversial issue since the perception is that HIV-infected women have more postoperative complications following a C-section compared to healthy controls. This study, like others, has shown an increased rate of relatively minor complications, but no important differences in terms of major complications. These data should be useful in counseling pregnant women who have a viral load >1000 c/ml at week 36 and are consequently candidates for C-section.
posted 8/10/2001





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