%0 Journal Article
%T Prenatal Ultrasound Screening for Fetal Anomalies and Outcomes in High-Risk Pregnancies due to Maternal HIV Infection: A Retrospective Study
%A A. Reitter
%A A. U. St¨¹cker
%A H. Buxmann
%A E. Herrmann
%A A. E. Haberl
%A R. Schl£¿£¿er
%A F. Louwen
%J Infectious Diseases in Obstetrics and Gynecology
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/208482
%X Objective. To assess the prevalence of prenatal screening and of adverse outcome in high-risk pregnancies due to maternal HIV infection. Study Design. The prevalence of prenatal screening in 330 pregnancies of HIV-positive women attending the department for prenatal screening and/or during labour between January 1, 2002 and December 31, 2012, was recorded. Screening results were compared with the postnatal outcome and maternal morbidity, and mother-to-child transmission (MTCT) was evaluated. Results. One hundred of 330 women (30.5%) had an early anomaly scan, 252 (74.5%) had a detailed scan at 20¨C22 weeks, 18 (5.5%) had a detailed scan prior to birth, and three (0.9%) had an amniocentesis. In seven cases (2.12%), a fetal anomaly was detected prenatally and confirmed postnatally, while in eight (2.42%) an anomaly was only detected postnatally, even though a prenatal scan was performed. There were no anomalies in the unscreened group. MTCT occurred in three cases (0.9%) and seven fetal and neonatal deaths (2.1%) were reported. Conclusion. The overall prevalence of prenatal ultrasound screening in our cohort is 74.5%, but often the opportunity for prenatal ultrasonography in the first trimester is missed. In general, the aim should be to offer prenatal ultrasonography in the first trimester in all pregnancies. This allows early reassurance or if fetal disease is suspected, further steps can be taken. 1. Introduction The majority of women living with HIV are in their reproductive years (ages 15¨C49) [1, 2]. The dramatic decrease in the risk of mother-to-child HIV transmission (MTCT) is leading to normality in the lives of couples affected by HIV, who want own children. In Europe, the reduction in MTCT to less than 1% is mainly due to highly active antiretroviral therapy (HAART). Effective HAART is resulting in suppressed viral load (VL); thus, a vaginal birth can be as safe as a planned caesarean section [3, 4]. Avoidance of breastfeeding and postnatal neonatal postexposure prophylaxis (PEP) further supports the effective reduction in MTCT [3¨C5]. Still there is a fear of higher pregnancy complications in women living with HIV [6]. The literature suggests that there is no increased rate of fetal malformations due to the HIV infection or HAART [6, 7]. A pregnant woman with HIV infection usually has intensified prenatal care including referral for prenatal ultrasound screening [8]. Prenatal ultrasound screening is being offered earlier and earlier [9]. Large studies of noninvasive prenatal screening have already indicated that it will lead to a decrease of
%U http://www.hindawi.com/journals/idog/2013/208482/