The incidence of complications after caesarean section in 156 HIV-positive women.

Important note: Information in this article was accurate in 1996. The state of the art may have changed since the publication date.

The incidence of complications after caesarean section in 156 HIV-positive women.

AIDS. 1995 Aug;9(8):913-7. Unique Identifier : AIDSLINE MED/96014966
Semprini AE; Castagna C; Ravizza M; Fiore S; Savasi V; Muggiasca ML; Grossi E; Guerra B; Tibaldi C; Scaravelli G; et al; Department of Obstetrics and Gynaecology, San Paolo Biomedical; Institute, Milan, Italy.

Abstract: OBJECTIVE: To investigate the risks of post-operative complications in HIV-positive mothers who undergo a caesarean section (CS) because the delivery cannot be safely accomplished by the vaginal route or to protect the infant from viral infection. DESIGN: In a multicentre study, we reviewed the incidence and type of post-operative complications in 156 HIV-positive women who underwent a CS. These results were compared with those observed in an equal number of HIV-uninfected women who matched for the indication requiring a caesarean delivery, the stage of labour, the integrity or rupture of membranes, and the use of antibiotic prophylaxis. SETTING: Seven teaching hospitals providing obstetrical care for mothers infected with HIV. RESULTS: We found that six HIV-infected mothers suffered a major complication (two cases of pneumonia, one pleural effusion, two severe anaemia and one sepsis) compared with only one HIV-negative woman who required blood transfusion after surgery. Minor complications like post-operative fever, endometritis, wound and urinary tract infections were significantly more frequent in HIV-positive women than controls. Multivariate analysis revealed that in HIV-infected women the only factor associated with a significant increase in the rate of complications was a CD4 lymphocyte count < 200 x 10(6)/l. CONCLUSIONS: The results of our study indicate that HIV-positive mothers are at an increased risk of post-operative complications when delivered by CS. The risk of post-operative complications is higher in HIV-infected women who are severely immunodepressed.

Keywords: Case-Control Studies Cesarean Section/*ADVERSE EFFECTS CD4 Lymphocyte Count Female Human HIV Infections/BLOOD/*COMPLICATIONS/IMMUNOLOGY Infant, Newborn Postoperative Complications/*ETIOLOGY Pregnancy Pregnancy Complications, Infectious/BLOOD/*ETIOLOGY/IMMUNOLOGY Risk Factors Support, Non-U.S. Gov't JOURNAL ARTICLE MULTICENTER STUDY
960228
M9621063

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