HIV and Pregnancy

HIV and Pregnancy

Nov 10, 2022

HIV and Pregnancy

HIV disease in humans can be caused by infection with either HIV-1 or HIV-2. HIV-1 is more prevalent of the two, has higher infectivity, virulence, and greater spread through heterosexual sex.

What is it?

HIV disease in humans can be caused by infection with either HIV-1 or HIV-2. HIV-1 is more prevalent of the two, has higher infectivity, virulence, and greater spread through heterosexual sex.

    The study of HIV during pregnancy holds great significance because many women are first diagnosed with HIV during pregnancy. Similarly, it is equally important in cases where one or both partners are HIV positive and wish to conceive. During recent years, universal HIV prenatal testing, antiretroviral therapy (ART), scheduled cesarean delivery for HIV positive women with elevated viral loads, appropriate ART for infants and avoidance of breastfeeding have shown encouraging results.

    HIV disease in humans can be caused by infection with either HIV-1 or HIV-2. HIV-1 is more prevalent of the two, has higher infectivity, virulence, and greater spread through heterosexual sex. The transmission rate of HIV from mother to child (vertical transmission) is 20% to 25% for HIV-1 versus about 5% for HIV-2. Vertical transmission of HIV is possible not only throughout pregnancy but also during childbirth and breastfeeding.

    In the absence of any treatment, the risk of vertical transmission of HIV during pregnancy, delivery, or breastfeeding is as high as 25 to 30%. However, with rigorous testing, preconception counseling, good ART adherence, scheduled cesarean delivery, and infant prophylaxis, the rate of vertical transmission is as low as <1 to 2% in the developed countries.

    In untreated HIV positive women, the risk of developing opportunistic infections increases with the fall in CD4 cell counts. Opportunistic infections like CMV and toxoplasmosis can cross the placenta and infect the fetus leading to congenital abnormalities. Also, untreated HIV infection has high chances of being passed on to the newborn in-utero, during delivery, or by breastfeeding.

    ART regimens themselves are also associated with many complications.

    Perinatal mood and anxiety disorders

    Perinatal mood and anxiety disorders

    Nov 1, 2022

    Perinatal mood and anxiety disorders

    Perinatal Mood Disorders are related to mood and anxiety symptoms that occur during pregnancy or up to one year postpartum

    What is it?

    Perinatal Mood Disorders are related to mood and anxiety symptoms that occur during pregnancy or up to one year postpartum

        Disorders Related to Pregnancy

        • Depression during pregnancy
        • Pregnancy loss
        • Infertility

          Disorders Related to Postpartum

          • Postpartum depression
          • Postpartum anxiety
          • Postpartum psychosis

          Depression During Pregnancy

          • Depression that occurs during pregnancy or within a year after delivery is called perinatal depression. Researchers believe that depression is one of the most common complications during and after pregnancy. Factors that may increase the likelihood of depression during or after pregnancy can include; history of depression or substance abuse, family history of mental illness, inadequate support from family and friends, anxiety about the fetus, problems with previous pregnancy or birth, marital or financial problems, and young age.

          Pregnancy loss

          • Experiencing miscarriage at any point in pregnancy can be a shocking and devastating event. Many women struggle with physical and emotional pain and grief that is powerful and overwhelming. Miscarriage can leave women feeling numb, helpless and isolated from others. Common reactions to miscarriage are sadness, anger, and guilt and depression.

          Infertility

          • Infertility occurs in 10-15% of couples of reproductive age. Investigation of the causes of infertility and treatment can bring on a “life crisis” that can tax a couple’s existing problem-solving resources, threaten achievement of life goals, and awaken unresolved past difficulties.

          Postpartum Depression (PPD) & Postpartum Anxiety Disorders

          • Postpartum anxiety disorders such as panic disorder, obsessive compulsive disorder and generalized anxiety disorder appear to be as common as postpartum depression and even coincide with depression. Perinatal anxiety symptoms can include the following: panic attacks, hyperventilation, excessive worry, restless sleep, and repeated thoughts or images of frightening things happening to the baby.

          Postpartum Psychosis

          • Another form of Postpartum Depression is Postpartum Psychosis. Postpartum Psychosis is a serious illness that can be severe and life threatening. The psychotic symptoms include delusions (thoughts that are not based in reality), hallucinations (hearing or seeing things that aren’t there) or disorganized thinking. Often mothers who develop postpartum psychosis are having a severe episode of a mood disorder, usually bipolar (manic-depression) disorder with psychotic features. It is essential for women to get evaluation and treatment immediately.

          Abortion and Causes of early pregnancy loss

          Abortion and Causes of early pregnancy loss

          Oct 25, 2022

          Abortion and Causes of early pregnancy loss

          Pregnancy loss, also referred to as miscarriage or spontaneous abortion, is generally defined as a nonviable intrauterine pregnancy before 28 weeks of gestation.

          What is it?

          Pregnancy loss, also referred to as miscarriage or spontaneous abortion, is generally defined as a nonviable intrauterine pregnancy before 28 weeks of gestation. Early pregnancy loss, which occurs in the first trimester, is the most common type. The nonspecific symptoms of vaginal bleeding and uterine cramping associated with pregnancy loss can occur in normal, ectopic, and molar pregnancies, which can be a source of frustration for patients.

              Symptoms

              • Most miscarriages occur before the 12th week of pregnancy.

              • Signs and symptoms of a miscarriage might include:

                • Vaginal spotting or bleeding
                • Lower abdominal pain or cramps or lower back pain
                • Tissue passing from your vagina

                Causes

                • Problems with the genes or chromosomes
                • Uncontrolled diabetes
                • Infections
                • Hormonal problems
                • Uterus or cervix problems
                • Thyroid disease

                Risk factors

                • Various factors increase the risk of having an early pregnancy loss

                  • Age. Women older than age 35 have a higher risk of miscarriage than do younger women. 
                  • Previous miscarriages. Women who have had two or more consecutive miscarriages are at higher risk of miscarriage.
                  • Chronic medical conditions. Women who have a chronic condition, such as uncontrolled diabetes, have a higher risk of miscarriage.
                  • Uterine or cervical problems. Certain uterine conditions or weak cervical tissues (incompetent cervix) might increase the risk of miscarriage.
                  • Smoking, alcohol and illicit drugs. Women who smoke during pregnancy have a greater risk of miscarriage than do nonsmokers. Heavy alcohol use and illicit drug use also increase the risk of miscarriage.
                  • Weight. Being underweight or being overweight has been linked with an increased risk of miscarriage.
                  Invasive prenatal tests. Some invasive prenatal genetic tests, such as chorionic villus sampling and amniocentesis, carry a slight risk of miscarriage.

                Prevention

                Often, there’s nothing you can do to prevent a miscarriage. Simply focus on taking good care of yourself and your baby:

                • Seek regular prenatal care.
                • Avoid smoking, drinking alcohol and illicit drug use.
                • Limit your caffeine intake. 

                 

                Components of preconception care

                Components of preconception care

                Oct 18, 2022

                Preconception care

                Preconception care is a care that aims to maximize the gains for maternal and child health. It is the provision of biomedical, behavioral and social health interventions.

                What is it?

                Preconception care is a care that aims to maximize the gains for maternal and child health. It is the provision of biomedical, behavioral and social health interventions.

                    Purpose of preconception care

                    • Establish lifestyle behaviors to maintain optimum health
                    • Identify and treat risks
                    • Conceive a pregnancy without necessary risk factors
                    • Prepare people psychologically for pregnancy and the responsibilities of parenthood

                      The components of preconception care

                      • Screening for common medical illnesses during pregnancy
                      • Supplementing Iron and Folic acid
                      • Information, counseling and education
                      • Monitoring nutritional status
                      • Managing identified health problems
                      • Promoting physical activity
                      • Advising on cessation of smoking and alcohol intake 
                      • Vaccination 
                      • Continue a regular follow up at a nearby health care service provider
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