H-454. Course of Labour in HIV Infected Pregnant Women with no Contraindication for Vaginal Delivery
Session: Poster Session: HIV: Pregnancy, Perinatal and Adolescent Infections
Saturday, October 25, 2008: 12:00 AM
Room: Hall C
Background: As no published data exists about the course of labor in HIV-infected women, we can wonder if there is a difference between infected and non infected women. A difference either linked to a different management of labor in HIV infected pregnant women, or due to a different evolution of labor related to the viral infection and to ART administration.Our aim is precisely to assess if, in this situation with no indication for an elective cesarean delivery, neither infectious nor obstetrical, the management and the evolution of labor are the same than in non HIV-infected women. Methods: A case-control study was designed with treated HIV-infected pregnant women with no contraindication, neither obstetrical nor virological, to vaginal delivery from the first January 2000 to the 31st of December 2005 in a single centre. Cases were matched with controls upon nulliparity, previous cesarean delivery and geographical origin. Results: 146 cases were kept for the analysis and matched with non HIV controls. No difference was shown in the course of labor, and in the fetal tolerance of labor. The cesarean delivery and assisted vaginal delivery rates were not different between the two groups. Episiotomy rate was significantly lower in HIV-infected pregnant women (29.6% vs. 45.6%, p= 0.01), with no difference in regard to the neonatal mean weight, the perineal laceration rate simple, or complex. No difference in neonatal outcome was observed, and no case of mother-to-child transmission of HIV occurred. Post-partum morbidity was not different between the groups, but in HIV-infected patients it was significantly higher when CD4+ cell count was lower than 200 RNA copy / ml than when upper (3.2% vs. 22.2%, p= 0.007). Conclusions: HIV-infected pregnant women treated by HAART with undetectable viral load and no obstetrical contraindication for vaginal delivery seem to have the same course of labor and vaginal delivery rate than non infected women.
Aminata Kahn1, Dominique Cabrol1, Elie Azria, MD2, Francois Goffinet1, Odile Launay, MD3, Thomas Schmitz1, Vassilis Tsatsaris1 and  E. Azria, None., (1)APHP, (2)H˘pital Bichat Claude Bernard, APHP UniversitÚ Paris Diderot., Paris, France, (3)Cochin Hospital, Paris, France