Amniocentesis in HIV Pregnant Women: 16 Years of Experience

• Author(s): Simões, M ; Marques, C ; Gonçalves, A ; Pereira, AP ; Correia, J ; Castela, J ; Guerreiro, C
• Date: 2013
• Persistent ID: http://hdl.handle.net/10400.17/1830
• Origin: Repositório do Centro Hospitalar de Lisboa Central, EPE
• Subject(s): MAC GIN; MAC PED; MAC MED MAF; Amniocentese; Efeitos Adversos; Amniocentese/Estatística e Dados Numéricos; Anti-Retrovirais; Terapêutica Anti-Retrovírica de Alta Eficácia; Estudo de Coorte; Infecção por HIV; Doença Iatrogénica; Transmissão Vertical de Doença Infecciosa; Gravidez; Complicações Infecciosas na Gravidez; Segundo Trimestre da Gravidez
• Document Type: Article
• Language: English

Description

The iatrogenic risk of HIV vertical transmission, calculated in initial epidemiologic studies, seemed to counterindicate invasive prenatal diagnosis (PND) procedures. The implementation of highly active antiretroviral therapy (HAART) represented a turning point in PND management, owing to a rapid and effective reduction of maternal viral load (VL). In the present study, we identified cases of vertical transmission in HIV-infected pregnant women who did amniocentesis in the second trimester of pregnancy (n = 27), from 1996 to 2011. We divided our sample into Group A--women under HAART when submitted to amniocentesis (n = 20) and Group B--women without antiretroviral therapy before amniocentesis (n = 7). We had 1 case of vertical transmission in Group B. Preconceptional or early first trimester HIV serology is essential to avoid performing an amniocentesis without antiretroviral therapy or viral suppression. When there is an indication for amniocentesis in an HIV-infected pregnant woman, it should be done if the patient is on HAART and, if possible, when VL is undetectable. Nowadays, with combined first trimester screening test to select pregnancies with high risk of aneuploidies, advanced maternal age is a less frequent indication to perform PND invasive procedures, representing an outstanding gain in prenatal diagnosis of this population.