Original Article| Volume 90, ISSUE 1, P73-76, May 2000

Maternal complications after caesarean section in HIV infected women


      Objective: To assess the intervention related risk in HIV-infected women, undergoing caesarean section (CS). Setting: Tertiary care center for high risk obstetrics and infectious diseases in pregnancy. Patients and methods: Thirty-three HIV-positive women and one hundred and sixty-eight controls, cross matched for age, weight, parity, obstetrical characteristics at delivery and indication for CS, were prospectively recruited for the study. Infection related characteristics, as mode of acquisition, drug abuse, immune status and stage of disease were also recorded. Complications of the intervention were evaluated according to infectious status and risk factors. Results: Post-operative complications were significantly more frequent among HIV-infected mothers. More advanced disease and maternal age were the risk factors statistically related to complications. Discussion: According to our data, CS carries a higher chance of post-operative complications in HIV-infected women, these complications being also related with the severity of infection (stage and duration of the disease). Given the characteristics of the population in the study (mode of acquisition, prevalence of early stage of the disease), the rate of complication is still relatively low compared to non-western, malnourished, drug-abusers groups.


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        • Petitti D.B.
        • Cefalo R.C.
        • Shapiro S.
        • Whalley P.
        In hospital maternal mortality in the United States: time trend and relation to method of delivery.
        Obstet Gynecol. 1982; 59: 6-12
        • Nielsen 83
        • Hokegard K.H.
        Postoperative cesarean section morbidity: A prospective study.
        Am J Obstet Gynecol. 1983; 146: 911-916
        • Rehu M.
        • Nilsson C.
        Risk factors for febrile morbidity associated with cesarean section.
        Obstet Gynecol. 1981; 57: 171
        • Harger J.H.
        • English D.H.
        Selection of patients for antibiotic prophylaxis in cesarean section.
        Am J Obstet Gynecol. 1981; 141: 752
        • Green S.L.
        • Sarubbi F.A.
        Risk factors associated with post caesarean section febrile morbidity.
        Obstet Gynecol. 1977; 49: 686
        • Ott W.J.
        Caesarean section: factors related to postpartum infection.
        Obstet Gynecol. 1981; 57: 171
        • Farrel S.J.
        • Andersen H.F.
        • Work B.A.
        Caesarean Section: indications and postoperative morbidity.
        Obstet Gynecol. 1980; 56: 696
        • Robinson G.
        • Wilson S.E.
        • Williams R.A.
        Surgery in patients with acquired immunodeficiency syndrome.
        Arch Surg. 1987; 122: 170-175
        • LaRaja R.D.
        • Rothenberg R.E.
        • Odom J.W.
        The incidence of intra-abdominal surgery in acquired immunodeficiency syndrome: a statistical review of 904 patients.
        Surgery. 1989; 105: 175-179
        • Semprini E.
        • Castagna C.
        • Ravizza M.
        • Fiore S.
        • Savasi V.
        • Muggiasca M.L.
        • et al.
        The incidence of complications after caesarean section in 156 HIV-positive women.
        AIDS. 1995; 9: 913-917
        • Bulterys M.
        • Chao A.
        • Dushimimana A.
        • Saah A.
        Fatal complications after Cesarean section in HIV-infected women.
        AIDS. 1998; 10: 923-924
        • The European mode of delivery collaboration
        Elective caesarean section versus vaginal delivery in preventing vertical HIV-1 transmission: a randomized clinical trial.
        Lancet. 1999; 353: 1035-1039
        • The International Perinatal HIV Group
        The mode of delivery and the risk of vertical transmission of human immunodeficiency virus type 1. a meta-analysis of 15 prospective cohort studies.
        N Engl J Med. 1999; 340: 977-987
        • Italian collab
        The italian collaborative study on HIV-infection in pregnancy. mother to child transmission of human immunodeficiency virus in italy: temporal trends and determinants of infection.
        Human Reprod. 1999; 14 N.1: 242-246
      1. NHI Consensus Development Task Force statement on cesarean childbirth. Am J Obstet Gynecol 1981, 902–9

        • Van Roosmalen J.
        Safe motherhood: caesarean section or symphysiotomy?.
        Am J Obstet Gynecol. 1990; 163: 1-4
        • Bulterys M.
        • Chao A.
        • Dushimimana A.
        Multiple sexual partners and mother to child transmission of HIV-1.
        AIDS. 1993; 7: 1639-1645
        • The European Collaborative Study
        Caesarean section and risk of vertical transmission of HIV-1 infection.
        Lancet. 1994; 343: 1464-1467
        • Tonnensen E.
        • Wahlgreen C.
        Influence of extradural and general anaesthesia on natural killer cell activity and lymphocyte subpopulations in patients undergoing hysterectomy.
        Br J Anaesth. 1988; 60: 500-507
        • The Pediatric Aids Clinical Trial Group Protocol 076 Study Group
        Reduction of maternal-infant transmission of human immunodeficiency virus Type 1 with zidovudine treatment.
        N Engl J Med. 1994; 331: 1173-1180