Decision for choice of delivery modes in HIV infected females

Abstract

Background:Recently, the prevalence of HIV is increasing in females during pregnancy and otherwise. This HIV infection also spreads to the neonatal and infants either through breastfeeding or during birth.Aims:The present trial was undertaken to determine the efficacy of elective caesarean section in the prevention of mother to foetus transmission of HIV infection, and to determine the perception, attitude, and knowledge of HIV infected pregnant females towards ECS as a mean of infection prevention. Also, the study assessed the comparison of planned and actual deliveries in HIV infected females.Materials and Methods: 26 subjects were asked to fill the questionnaire which had the demographic data of the subjects including socio-economic status, obstetric and gynaecologic history, associated medical history, questions related to present pregnancy, delivery mode and its decision, and knowledge and attitude of the participants towards Elective Caesarean Section. The collected data were subjected to statistical evaluation and the results were formulated.Results: The majority of females said the delayed recovery remained the most common reason for preferring the vaginal deliveries over the caesarean  section in 65.38% of subjects (n=17). The second most common reason was delayed postoperative complications after discharge including infection and death in 53.84% (n=14) subjects followed by a higher death rate in caesarean as opted by 50% (n=13) study subjects. The other factors were a pain in 34.61% (n=9), more cost of the caesarean section in 15.38% (n=4), and 11.53% (n=3) subjects believed that after caesarean section fertility is reduced. In females who were aware of HIV status before delivery, only 15% greed for ECS, whereas, in females who were detected for HIV during pregnancy, 67% (n=4) agreed for elective caesarean section.Conclusion:The study concludes that although females had a fear of surgical caesarean section related to the pain, cost, delayed complications, and even death, however, there is increased acceptability towards elective caesarean section post-counselling in HIV positive pregnant females.

Keywords:Elective caesarean section, HIV, Pregnancy, perinatal transmission, vaginal delivery.