Just two decades ago, the desire of an HIV-infected woman to have a child was considered, if not illegal, then shameful and immoral.

Experts were sure that HIV infection and pregnancy- concepts are completely incompatible. And the possibility of transmission of infection from mother to baby frightened the HIV-infected women themselves. In addition, childbirth could pose a huge danger to the mother. However, in recent years, completely new means have appeared to combat HIV, and today a woman with a similar diagnosis is quite capable of conceiving, bearing and giving birth to an absolutely healthy child.

How to recognize HIV during pregnancy?

The incubation period of this disease can last from two weeks to several months, depending on the state of the immune system. First signs of HIV can be quite vague and most often women at an early stage simply ignore them. Most women learn about the diagnosis only in its acute phase, which is characterized by:

• strong increase in temperature;
• the appearance of muscle pain;
• unpleasant sensations in the joints and throughout the body;
• various types of gastric dysfunction;
• rashes on the skin, body and limbs;
• changes in the size of the lymph nodes.

Very often, a pregnant HIV-positive woman feels weakness, headache, chills, and fatigue. All these symptoms are also characteristic of completely healthy pregnant women. The acute stage gradually flows into the latent stage, when the disease practically does not manifest itself at all. In the absence of proper treatment, a woman’s immunity rapidly declines, and her body becomes especially susceptible to various viruses, fungi and infections.

Important! The chance to carry and give birth to a full-fledged child exists for women whose disease is in the first or second stage of development. In this case, continuous treatment of the disease is a prerequisite.

Diagnosis of the disease

If you promptly determine the presence of HIV infection in an expectant mother, this will give her every chance to successfully conceive, carry and give birth to a healthy child. That is why it is so important to undergo a full examination at the stage of pregnancy planning. HIV infection can be detected using the following methods:

1. Polymerase chain reaction- for this it is necessary to draw blood, as well as examine the sperm and biological fluids of both partners. Thus, it is possible to establish the presence and type of HIV infection, if any, as well as its concentration. This method allows you to diagnose the disease within two weeks after the moment of infection.
2. Enzyme immunosorbent screening- the most commonly used and effective method for detecting HIV. To do this, partners donate venous blood to check for the presence of specific antibodies to HIV. If such testing gives a positive result twice, then the presence of infection is refuted or confirmed by a special additional test (immunoblot test).

Important! HIV diagnosis is recommended in the first trimester of pregnancy. However, the risk of disease transmission remains throughout pregnancy, so you should be examined at a later stage, as well as after the birth of the child.

Impact of HIV on pregnancy

The presence of HIV infection can negatively affect the course of pregnancy. In some cases, pregnant women with HIV-positive status may develop:

• tuberculosis, pneumonia, various diseases of the genitourinary system;
• chlamydia, herpes, syphilis and other sexually transmitted infections;
• abnormal intrauterine development of the fetus, in rare cases - fetal death;
• placental abruption or disruption of the integrity of the amniotic membrane;
• frequent miscarriages.

Many HIV-infected people experience premature birth, resulting in underweight babies. In addition, during the planning process, there is a high probability of embryo implantation outside the uterine cavity - we are talking about an ectopic pregnancy.

Methods of transmission of HIV infection

Pregnancy in an HIV-infected woman must be carefully planned. However, it also happens that the expectant mother learns about her diagnosis while already pregnant. In this case, she will have to undergo a course of treatment with special drugs aimed at fighting the virus, regularly monitor the level of antibodies in the body, and also monitor the development process and condition of the unborn child.

Of course, the very combination of pregnancy and HIV is extremely dangerous for both the unborn child and the mother, but if a woman is ready to strictly follow all doctors’ instructions and has an understanding of the risks, she has every chance of becoming a happy mother.

Exists three main ways in which HIV can be transmitted from mother to child:

1. Through the blood- during the gestation period, the fetus and the expectant mother have a common circulatory system, thus there is a possibility of transmission of infection while in the womb.
2. During labor- when the maximum permissible levels of infection are reached, there is a chance of HIV transmission during childbirth through amniotic fluid. In most cases, delivery in HIV-positive pregnant women occurs by cesarean section.
3. During breastfeeding- The baby can become infected with HIV from the mother during breastfeeding. The risk of transmission in this case is approximately 25%, since without special precautions, mother's milk contains a fairly high concentration of infection. Most often, HIV-infected mothers in labor prefer artificial feeding.

How to avoid passing HIV to your child?

Many families suffering from the human immunodeficiency virus express a desire to reproduce a child, sometimes even more than one. In this case, even the most seemingly insignificant details must be taken into account, since the possibility of infection of the fetus exists even during the process of conception. Of course, the reproductive cells of the parents cannot be a source of infection, but the infection is present in the fluids of both partners.

There are several ways to conceive relatively safely for such couples. In cases where only a woman is the carrier of the virus, she can undergo artificial insemination, namely, we are talking about artificial insemination. In families where the spouse is infected, you can resort to one of the following fertilization options:

1. Sexual intercourse during ovulation- the method is used quite rarely, since the risk of infection of a woman remains quite high.
2. ECO- in this case, the fusion of sperm and egg occurs in the laboratory, after which the developing embryo is implanted into the woman’s uterine cavity.
3. The partner's seminal fluid undergoes special purification, and is inserted into the partner’s vagina during ovulation. Thus, the threat of transmission of the virus to the woman and unborn child is significantly reduced.

Important! The safest method of conception for HIV-infected women is the method of artificial conception using healthy donor material. However, not all married couples are ready to take this step.

During gestation, childbirth and during feeding, the probability of a child becoming infected is quite high (about 25%) if proper precautions are not taken. Modern techniques can reduce this probability to approximately 2-3%, and this is a very significant shift. What needs to be done for this?

1. First of all, do not neglect taking HIV medications. As a rule, a woman with this terrible diagnosis must take medications that contain a certain substance aimed at fighting HIV throughout the entire period of pregnancy and after childbirth. Thus, the chance of transmitting the disease is significantly reduced.
2. Childbirth by caesarean section. In this case, it is possible to significantly minimize the child’s contact with the mother’s fluids. Natural childbirth in HIV-infected people is allowed, but only in certain cases.
3. Artificial feeding. An HIV-infected woman will most likely have to stop breastfeeding her baby. Today, on the shelves of children's stores there is a fairly wide range of food for newborns, which practically does not differ in properties from natural breast milk.

Is pregnancy dangerous for the woman herself?

According to statistics, pregnancy in most cases is not capable of negatively affecting the condition of an HIV-infected expectant mother. However, some anti-HIV drugs must be avoided during pregnancy because they are extremely harmful to the development of the fetus. In addition, like any healthy woman, a woman with HIV infection should pay special attention to her lifestyle throughout pregnancy, namely:

• completely give up bad habits - smoking and alcohol;
• do not take drugs;
• review your diet, making it as balanced as possible;
• Strictly follow the rules for taking medications aimed at combating HIV.

Important! There are drugs that can cause the development of congenital anomalies in the fetus, which is why their use must first be discussed with your doctor!

In the Department of Reproductology, Alexander Pavlovich Lazarev respects and understands the desire of HIV-positive women to have their own children. And fortunately, even such a terrible diagnosis cannot put an end to the opportunity to give a new life. However, every woman with HIV must realize that she and her husband will have to go through a difficult long journey and make a lot of efforts to ensure that their child is born healthy.

Modern medicine can reduce the likelihood of HIV transmission from mother to child to 2%. From now on, HIV is not a death sentence at all, and in our time this disease does not put an end to the dream of motherhood. You can give yourself and your spouse a completely healthy, strong baby, who will give you a lot of happiness and push negative thoughts about your illness into the background.

Pregnancy with HIV infection is carefully planned. But there are cases when a woman finds out about the infection while she is already pregnant. She will undergo antiretroviral therapy (ARV), monitoring the level of essential antibodies, and monitoring the condition of the fetus. To avoid health complications, it is necessary to adhere to the instructions of specialists, because the main task is the birth of a healthy child.

Is it possible to conceive with HIV infection?

Despite the risk of infecting the unborn child with HIV infection, many families where one of the spouses, and sometimes both, are immunodeficient, decide to have a baby. In such a difficult situation, even the method of conception can reduce the risk of infection of the baby. In fact, the germ cells of both parents are sterile, but the virus is found in abundance in biological fluids.

In this regard, doctors have provided several methods of conception in which this possibility is minimized:

1. If a woman is sick, she is asked to undergo the procedure of artificial insemination - during ovulation, that is, the maturation and release of an egg ready for fertilization, pre-collected male sperm is introduced into the vagina.

2. For families and couples where a man is infected, several options are considered:

• Semen purification HIV-positive partner and direct insertion into the woman’s vagina when the mature egg has already been released into the abdominal cavity. This method reduces the risk of infection of the woman, and, consequently, the child.
• In Vitro Fertilization, when, using the laparoscopic method, the female gamete is collected, and in men, sperm are separated from the seminal fluid. The germ cells are artificially fertilized and then placed in the uterine cavity.
• Easy way– unprotected sex is used extremely rarely. To do this, the day of ovulation must be accurately determined so that conception occurs for sure. Otherwise, with repeated attempts, the woman’s risk of infection increases.

3. There is also a safest option– artificial conception of a woman through the seed of a healthy man, eliminating any risks associated with the body of the mother and baby, but not all couples are ready to take such a step, based on its moral and legal aspects.

How is the diagnosis done?

A timely detected infection can help a woman give birth to a normal baby, so it is advisable to take HIV tests at the pregnancy planning stage. For this, venous blood is taken from both the expectant mother and the intended father.

The main diagnostic procedures in this case:

• ELISA- linked immunosorbent assay. Laboratory blood test to determine specific antigens and antibodies to HIV proteins. If the serum gives a positive result two times in a row, an immunoblot test is performed, which excludes or confirms infection.
• Polymerase chain reaction– for such an examination, blood is taken, and biomaterial of sperm and secretions from the woman’s genital organs are also collected. The purpose of the study is to establish the genotype (HIV-1, HIV-2) and determine the concentration of the virus in the body. The method helps determine the presence of infection within 10-15 days after infection, but usually it is used to confirm enzyme immunoassay screening.

During pregnancy, it is advisable for a woman to be diagnosed early - within the first two months. Since there is a risk of later infection, it is recommended to conduct HIV tests at 30 and 36 weeks of gestation, as well as after childbirth.

Main symptoms of HIV infection in pregnant women

HIV infection can appear as early as 2 weeks after a woman is infected, but sometimes, when the immune system is strong, signs of the disease appear much later - after several months. Their one-time appearance may not raise any suspicion of a health hazard, so the diagnosis of immunodeficiency becomes unpleasant news.

Pregnant women in the acute stage experience the following typical symptoms:

• temperature rise to high values;
• severe myalgia – muscle pain;
• body aches, joint pain;
• intestinal dysfunction in the form of diarrhea;
• skin rashes on the face, torso and limbs;
• enlarged lymph nodes.

A pregnant woman may have such general symptoms as weakness, fatigue, chills and fever, and headache. They can easily be confused with feeling unwell during a common cold.

After an exacerbation, a latent stage begins, during which practically no obvious manifestations of the disease are detected. If an immunodeficiency condition quickly becomes chronic, a woman may develop various diseases caused by fungal, bacterial and viral infections.

During pregnancy and HIV infection, it is realistic to carry and give birth to a healthy child only if the disease is at the initial and second stages of development. And only if the woman immediately begins treatment and antiretroviral prophylaxis.

How does HIV infection affect pregnancy?

It is known that HIV infection can negatively affect the course of pregnancy.

Pathology can provoke in a woman:

• development of opportunistic infections: tuberculosis, disruption of the urinary organs and other complications associated with immunodeficiency and negatively affecting pregnancy;
• infection with herpes, syphilis, trichomoniasis and other sexually transmitted infections that can lead to stillbirth of a child;
• unsatisfactory development of the fetus, and sometimes intrauterine death of the baby;
• violation of the fetal membrane and detachment of placental tissues;
• spontaneous miscarriages, which are much more common than in uninfected mothers.

Due to the influence of a dangerous infection, patients with HIV are more likely to have premature births, and children are born with less weight. If pregnancy is accompanied by characteristic symptoms of the disease, the risk of negative effects on the course of pregnancy also increases.

At the conception planning stage, there is a high percentage that the embryo can be implanted outside the uterine cavity, which increases the risk for the life of the woman herself and the death of the fetus.

Transmission of the virus and its effect on the fetus

Despite the fact that there are cases of healthy offspring being born from an infected mother, the risk of infection of the child always exists.

Transmission of the HIV virus can occur:

• During pregnancy– the fetus can become infected if, against the background of HIV, multiple pathological processes develop in the mother’s body, including bacterial infection of the placenta, amniotic fluid and umbilical cord. As a result of such a lesion, prenatal rupture of amniotic fluid, stillbirth, or miscarriage may occur. Childbirth, however, is difficult and protracted.
• At the time of birth– passing through the birth canal, the baby comes into close contact with the mother’s mucous tissues and any slight damage to the skin allows the virus to enter the newborn’s body. To protect it, a caesarean section is used at 38 weeks of pregnancy; the operation halves the risk of infection, but there is no guarantee in such a situation.
• After labor– the infection can pass from mother to baby through breast milk; the infection is not transmitted to the child by other means.

As a result of infection during and after childbirth, a baby may experience pneumonia, chronic diarrhea, ENT diseases, encephalopathy, anemia, kidney dysfunction, dermatitis, herpes, and delayed mental and physical development.

The course of pregnancy against the background of HIV

During pregnancy, due to the irresponsible attitude of the woman, as well as complications associated with the infection, there is a high percentage of miscarriages, placental abruption, and growth retardation of the child.

First trimester

At this time, as throughout the entire period of gestation, the immunological indicators of CD4 white blood cells decrease markedly, and many concomitant infections can occur. Most often, the expectant mother has to undergo treatment with special drugs that prevent transmission of the virus to the baby. But usually treatment begins from 10 to 14 weeks, and before that the woman does not use any medications, as they can have a detrimental effect on the development of the baby.

Second trimester

Starting from the 13th week, intensive therapy with the main antiretroviral drugs is prescribed, these are:

• Nucleosides and nucleotides – Phosphazide, Abacavir, Tenofovir, Lamivudine.
• Non-nucleoside reverse transcriptase inhibitors - Efavirenz, Nevirapine, Etravirine.
• HIV protease inhibitors – Nelfinavir, Ritonavir, Atazanavir.

In addition to medications in the early and later stages of pregnancy, women are recommended to take vitamin complexes, folic acid, and iron supplements.

Third trimester

Highly active drugs are used to suppress the retrovirus HAART (the most effective Retrovir (Zidovudine) is prescribed at 7 months), often they are used in combination with each other, but can have significant side effects in the form of liver dysfunction, allergies, decreased blood clotting, and dyspepsia. Therefore, doctors often adjust therapy or replace some drugs with others that are safer for the fetus.

With antiviral therapy throughout pregnancy, following proper nutrition and other doctor’s recommendations, the risk of infection is reduced to 2%, despite the fact that without treatment, 30 out of a hundred children become infected - during pregnancy, childbirth and the postpartum period.

Management of pregnant women with HIV infection

When pregnancy occurs against the background of HIV infection, a crucial period begins for a woman, when all efforts should be aimed at giving birth to a healthy baby. All this time she will be under the supervision of doctors - AIDS center specialists will conduct a full medical examination and will support the woman throughout her pregnancy, as well as her direct gynecologist-obstetrician and infectious disease specialist.

In this difficult time, a woman needs:

• take antiviral drugs;
• regularly visit an infectious disease specialist to identify dangerous diseases that arise due to weakened immunity;
• if the fetus is in normal condition, medications can be prescribed to prevent spontaneous abortion, which often occurs in the early stages of gestation;
• It is mandatory to undergo monthly tests to study the state of the immune system, as well as a general and extensive blood test.

Constant monitoring is necessary for the effective use of ARV and IVART drugs, in addition, this is how the most favorable time and option for delivery are determined.

Prevention

At conception, preventing the child from becoming infected consists of purifying the sperm of an infected father, in vitro fertilization, and conception using the sperm of a healthy donor. In women, antiviral treatment is acceptable to reduce the viral load before planning pregnancy.

Throughout pregnancy, before and after childbirth, chemoprophylaxis of HIV infection with drugs is carried out.

If a woman is already carrying a child, the following preventive measures are applied:

• a pregnant woman with the immunodeficiency virus can only have sexual intercourse using a condom;
• when prescribing medical procedures, only disposable or maximally sterilized instruments should be used;
• Perinatal invasive diagnostics are prohibited;
• prevention of diseases and complications associated with HIV infection is carried out;
• If the fetus is infected before the 12th week, termination of pregnancy may be proposed.

Regarding childbirth, optimal delivery is planned in advance. Basically, surgical extraction of the newborn is used.

After the birth of the baby, the woman must stop breastfeeding and continue the course of antiviral treatment. In some cases, drug prophylaxis against retroviruses is also prescribed for a newborn.

The desire of some couples to have a child cannot be stopped even by such a terrible diagnosis as HIV infection. But a woman needs to understand that she will have to go through a difficult path and make considerable efforts to ensure that the baby is born healthy. This is a big responsibility and an undeniable risk that must be remembered.

Next article.

If a person is a carrier of HIV infection, this does not mean that he should give up his life. Modern medicine has studied the virus enough to help someone infected with HIV live a fairly long life and still feel good. Men and women with HIV can create families in which sooner or later the question of having a child arises. In this case, it is not necessary for both partners to be carriers of the virus; either only the man or only the woman can be infected. In each of the possible situations, there are options for the spouses to give birth to a healthy child without a virus in the blood.

The fact that an HIV-infected woman can give birth to an uninfected child is not fiction. To do this, it is enough to plan your pregnancy together with a specialist, as well as undergo special treatment throughout your pregnancy. Statistics provided by WHO indicate that taking preventive measures before and during pregnancy reduces the risk of transmission of the immunodeficiency virus from mother to child to 2-3%. Moreover, if you do not interfere with the pregnancy process in order to protect the fetus from infection, the risk of infection is 20-45%.

As you know, women are the most vulnerable to HIV. Unfortunately, despite the widespread promotion of protected sex and personal hygiene rules, every year in Russia there are more and more women of reproductive age who are forced to face HIV. Most often, women are infected between the ages of 18 and 30 – the most favorable age for the birth of offspring. But HIV has ceased to be a reason for refusing to have children. To date, more than 6,000 babies have been born to HIV-infected women. However, cases cannot be ruled out when women prefer to have an abortion rather than risk it. Such situations, as a rule, are caused by the lack of necessary up-to-date information, professional psychological assistance and lack of support from family and friends.

Often, women find out that they are HIV-infected already during pregnancy, when they register at the antenatal clinic and begin to undergo mandatory examinations. To prevent this, both partners should undergo examinations and tests at the stage of planning a child. But if there are no test results, but you are pregnant, you should go to an appointment with an obstetrician-gynecologist and register for pregnancy as early as possible.

Conceiving a child in a couple with HIV infection

There are a lot of questions surrounding the topic of conceiving a child in families where both or one of the spouses is infected with the immunodeficiency virus. People are interested not only in the health of the unborn child, but also in when is the best time to take this serious step, how to get pregnant and protect a partner who is not an HIV carrier.

Not everyone knows that the egg and sperm do not carry a virus; they only contain the DNA of the future parents. However, HIV cells are present in both vaginal secretions and ejaculate. It is also dangerous for spouses infected with various types of HIV or a drug-resistant virus to have unprotected sex in order to have a child, as there is a risk of re-infection of partners. If a woman is infected, she can transmit the virus to her child in the following ways:

• during pregnancy;
• during delivery;
• when breastfeeding.

The risk of a child contracting HIV through one of the first two routes can be minimized with the help of special treatment that prevents transmission of the virus to the fetus. But infection will be inevitable if a woman carrying HIV breastfeeds her baby, since virus cells are contained in large quantities in breast milk. In addition, infection is also possible through careless handling of a child after he or she has passed infancy. Therefore, you need to get used to being extremely attentive to your actions and his healthy future from the very beginning - even before the baby is born.

Safety of future parents

As mentioned earlier, if a couple in which one or both partners are diagnosed with HIV wants to give birth to a child, it is necessary to take care not only of the unborn child, but also of the spouses themselves. To prevent an infected man and woman from becoming carriers of various types of viruses, as well as from infecting healthy members of a couple, there are various assisted reproductive technologies.

Alternative methods of conception in families with HIV

1. If only a woman is HIV-infected

If only the woman is a carrier of HIV, then to protect the man from the virus, conception can be achieved through artificial insemination. To do this, you need to find a clinic that practices this particular ART method. The woman determines the period during which ovulation should approximately occur; as a rule, with a 28-day cycle, ovulation occurs on the 14th day. On the day of expected ovulation, an artificial insemination procedure is prescribed. Before this, the man must donate sperm, which will be injected into the patient’s vagina.

2. If only a man is infected with HIV

• In such a situation, the safest method of conception, according to many doctors, would be artificial insemination. The HIV-infected partner provides a semen sample, which is subsequently cleared of the virus in the laboratory. With the help of a specialist, the woman determines the day of ovulation and it is at this time that purified seminal fluid is injected into her vagina. This method is not only safe for the expectant mother and child, but also quite effective against ART. However, before artificial insemination is carried out, the partner must undergo tests to determine how fertile he is, that is, whether he has the ability to fertilize.
• IVF – in vitro fertilization. In order to carry out IVF, germ cells are taken from both the man and the woman. The husband donates sperm, and mature eggs are collected from the wife using a low-traumatic endoscopic procedure - laparoscopy. Then two sterile germ cells are combined “in vitro”, the egg is fertilized by a sperm, and a healthy, viable embryo is placed in the woman’s uterus. It is advisable to use IVF only if the couple has problems conceiving.
• Using donor sperm. If a man is infected, a woman can use a sperm bank and undergo artificial insemination using sperm from an HIV-negative donor. With this method of conception, the risk of infecting the woman and child with the human immunodeficiency virus is zero, but not all couples are ready to decide on this due to the ethical side of the issue.

Where to start planning for pregnancy with HIV?

Knowing her family situation, a woman should consult an obstetrician-gynecologist several months before the expected date of conception. As practice shows, the more attention is paid to pregnancy planning and preparation for it, the better for the mother and her unborn child.

You need to know that a woman’s risk of infection increases if she has sexually transmitted diseases in acute or chronic form, chronic diseases of the reproductive system in the acute phase, as well as diseases of other organs that lead to a deterioration in her condition and well-being. Therefore, before a planned pregnancy, it is necessary to undergo the necessary treatment and get rid of the largest number of diagnosed diseases. For an HIV-infected woman, it is important to know the stage of development of her disease, indicators of immune status, viral load, and the presence of opportunistic infections.

Feel free to contact HIV and AIDS counselors to ask all your questions, ask for advice, learn about the experiences of couples with a similar diagnosis and what options are available to you.

You can become the mother of a healthy child with HIV. To do this, you just need to contact a specialist in time, prevent the transmission of HIV to the fetus, and also take yourself and your unborn child seriously from the very beginning.

For many women, deciding to become pregnant is a real difficulty. She faces a difficult task, because she needs to think about whether she can risk her own health and the health of her unconceived unborn child. The desire to give birth is intertwined with fear and doubt if a man or woman is HIV positive.

Everyone understands perfectly well that HIV is a popular causative agent of AIDS. There are two types of HIV: HIV 1 and 2. HIV 1 is the most common, it is more insidious, because after it 35% of carriers develop AIDS. And for HIV 2 it is only 10%. The average time for AIDS to develop from the moment of infection is about 10 years.

Experts were able to isolate the infection from some fluids of the human body: tear fluid, saliva, urine, semen, blood. Today, infections are registered only through breast milk, sperm, and blood.

Conceiving a child

If a couple with the HIV virus wants to have a baby, they should consult a doctor and seriously think about it. This does not mean that all responsibility should be shifted to the doctor. His role is to conduct a consultation, and the man and woman, taking into account all the risks, make their own decisions.

Until today, it has not been proven that HIV during pregnancy affects health. Therefore, if certain conditions are met, pregnancy is still possible.

There is some difference if, at conception, the carrier of the infection is a woman or a man.

If a woman is infected with HIV:

Today in medicine there are various methods of conception, in which the transmission of infection to the fetus is significantly minimized. Unfortunately, no method provides a 100% guarantee that the child will not become infected.

If a man is HIV-negative and a woman is infected, then the man is at risk of becoming infected when he conceives. To prevent this from happening, the expectant mother needs to use insemination. To do this, the man's sperm are collected in a sterile container and the woman is fertilized during a favorable period for conception, in other words, during ovulation.

If a man is infected with HIV:

Then there is a risk of infecting the woman. The baby will not be infected through sperm, but will become infected from the woman. To protect the wife, doctors recommend planning pregnancy on the most favorable days for fertilization, as well as when the husband’s viral load is undetectable.

There may be another option - cleaning sperm from the family fluid. Then the viral load decreases, and as a result the virus is not detected. Italian doctors performed this method on approximately 200 women, and none of them became carriers of the virus.

There is another method of artificial insemination, in which I use the sperm of another man to conceive.

If both spouses are infected with HIV:

Then the risk of infection of the baby is maximum. Also, during unprotected sexual intercourse, partners can become infected with various diseases.

Pregnancy

If a woman is infected and she is pregnant, then in this condition she should be under very strict medical supervision. If during pregnancy the expectant mother stops using antiviral medications, there is a risk of rapid reinfection. And this increases the chances of vertical infection of the baby. In principle, even during pregnancy, the baby can become infected in the womb or during childbirth. There is evidence that infection from woman to baby occurs at the end of pregnancy. The risk of transmitting the virus to a baby from an infected woman is one in seven.

If the virus is first detected in a woman during pregnancy, she is told the truth about the possible risks and then given a personal choice: to plan a pregnancy or not. The pregnancy itself in an HIV-positive woman comes with some complications.

Childbirth period

During childbirth, there is a high risk of infecting the baby, because he is exposed to the vaginal sector and blood. Also, the risk of infection increases in the presence of various wounds and injuries that form as a result of surgical manipulations or the birth process.

If a pregnant woman is taking contraceptive medications, she is unlikely to be recommended for a cesarean section. And all because in her cases the chances of transmitting the infection to the baby are equal in both cases. Therefore, if therapy has not been carried out, then a cesarean section is chosen.

A woman is given the drug Zidovudine - this is a very useful prophylactic agent.

Postpartum period

If a child does not become infected with the virus during conception, pregnancy and childbirth, this does not mean that he will not become infected in the postpartum period. It has been proven that the virus is transmitted when a woman feeds her baby with breast milk. Therefore, after giving birth, a woman is advised not to breastfeed her baby. Also, the mother is taught the rules of caring for the child so that she poses minimal risk to him. If a woman follows all precautions, the risk of infection will decrease many times.

What should you think about?

You need to think about whether you agree to pregnancy and agree to such a risk. You must understand: if a baby is infected in utero or during childbirth, in 80% of cases he will develop AIDS by the age of six. Will anyone raise a child if the parents are not doing well?

The decision regarding pregnancy is made only by the couple. And the doctor should support and help in every possible way.

Pregnancy is wonderful moments, it is dreams and dreams, it is real happiness, especially if it is long-awaited. The expectant mother is making plans for how her life will change with the birth of her baby. And in the midst of all this, like a point-blank shot, the diagnosis of HIV can strike. The first feeling is panic. Life is falling apart, everything is going topsy-turvy, but you need to find the strength to stop and think carefully. Pregnancy and HIV are not a death sentence. In addition, you first need to confirm how reliable the diagnosis is.

Better late than even later

Indeed, for many women it is unclear why they need to constantly undergo tests for various infections during pregnancy. After all, they have a happy family, and this definitely cannot happen to them. In fact, pregnancy and HIV very often go hand in hand. It’s just that this disease is very insidious; it can be completely invisible for ten to twelve years. Even if there are a couple of lumps (lymph nodes) on the neck, this may go unnoticed. In some cases, the temperature may rise slightly, sore throat, vomiting and diarrhea may appear.

In order to identify the disease, special laboratory tests are needed. The program for the protection of motherhood and childhood necessarily includes careful consideration of the expectant mother. This is why pregnancy and HIV are two concepts that are often found together. Perhaps, if not for the interesting situation, the woman would never have consulted a doctor.

Diagnostics

As has already been said, the only reliable method of diagnosis is laboratory tests. When a woman registers for pregnancy, she is sent for tests from the first day. It should be noted that they cannot be prescribed forcibly, without the consent of the patient. But this is in your interests, because pregnancy and HIV, occurring simultaneously in the body, should not be left without the supervision of a doctor.

The most popular diagnostic method is ELISA, which detects antibodies to HIV in the patient’s blood serum. PCR allows you to detect the virus cells themselves in the blood. Typically, this examination is carried out when there is already a suspicion of HIV in order to accurately make a diagnosis.

If the doctor tells you such unpleasant news, you should not panic. HIV and pregnancy can coexist quite peacefully, and you may well give birth to a healthy baby. At the same time, we must not forget that it is vital for you to work closely with your doctor, take tests and follow recommendations.

Could there be an error?

Of course it can! This is why you should definitely undergo further examination, especially if you are confident in your partner. The fact is that primary diagnosis is carried out using the already designated ELISA method, which can give both false-positive and false-negative results. HIV and pregnancy at the same time is a blow for any expectant mother, but we must remember that the results obtained are not completely reliable.

A false negative result may occur if the infection occurred very recently. That is, a person is already a carrier, but the body has not yet had time to react and develop protection, antibodies, which doctors find. False-positive tests are even more common, especially in pregnant women. The reasons lie in the physiology of this difficult period. Of course, anyone will not be able to sleep when such news arrives, but first of all you need to weigh how possible such a development of events is, what were the prerequisites for this, and, of course, continue the examination.

Course of pregnancy

HIV and pregnancy can run their course without affecting each other too much. Pregnancy does not accelerate the progression of infection in women who are at an early stage of disease development. According to statistics, the number of pregnancy complications in this case in infected women practically does not exceed that in women without HIV. The only exception is that bacterial pneumonia is diagnosed somewhat more often.

An HIV test during pregnancy is also necessary to assess the stage of development of the disease. By the way, if we compare the mortality rate between those who gave birth and those who refused to do so (we are talking about termination of pregnancy after diagnosis), there are practically no differences.

However, as you already understand, the course of pregnancy very much depends on how long ago the disease has been developing, what stage it was at the time of conception, as well as on the condition of the body. The later the stage, the more complications may arise. These may include frequent and severe bleeding, anemia and premature birth, stillbirth, low fetal weight, and postpartum endometritis. Thus, the more severe the disease, the less chance of carrying and giving birth.

Clinical picture during pregnancy

This point is especially important for those women who learned about their disease already during pregnancy. How does HIV progress during pregnancy, what are the symptoms and treatment of this disease in expectant mothers? These are questions the answers to which could help many women evaluate what is happening to them and take adequate measures. But, unfortunately, it is difficult to describe them more or less accurately. The fact is that the immunodeficiency virus develops and progresses against the background of a weakening of the body’s protective functions. And the more the immune system retreats under its onslaught, the more pronounced the symptoms will be.

Usually, 6-8 weeks after infection, a person begins to experience the first signs, which the expectant mother can easily mistake for a typical pregnancy picture. At this time, you may experience increased fatigue, fever and decreased performance, as well as diarrhea.

What is the main difficulty? This stage does not last long - just two weeks, and the symptoms subside. Now the disease is taking a latent form. The virus enters the persistence stage. The period can be very long, ranging from two to 10 years. Moreover, if we talk about women, then it is they who have a tendency to have a long latent stage; in men it is shorter and does not exceed 5 years.

During this period, all lymph nodes enlarge. This is a suspicious symptom that requires examination. However, here lies the second difficulty: enlarged lymph nodes during pregnancy are normal and very common in healthy people. However, this symptom should definitely alert the expectant mother. It’s better to be on the safe side than to lose precious time.

Intrauterine development of the baby

In this matter, doctors were very interested in one point, namely, at what time the infection occurs. A lot of information for this was provided by tissues from spontaneous miscarriages and infected mothers. Thus, it was found that the virus is capable of causing intrauterine infection already in the first trimester, but the likelihood of this is not too high. In this case, children are born with the most severe lesions. As a rule, they do not live long.

More than half of all cases of infection occur in the third trimester, the period immediately before childbirth and the birth itself.

It is also interesting that until recently, the detection of antibodies to HIV in the blood of a pregnant woman was an indication for immediate termination of pregnancy. This is associated with a high risk of fetal infection. However, today the situation has changed. Thanks to modern treatment, a woman is not sent even for a planned caesarean section if she receives the necessary treatment.

The probability of infection of the baby

As we know, according to statistics, the immunodeficiency virus is transmitted from mother to child. This is one of three ways of infection. HIV positive during pregnancy increases the risk of having a child with a congenital disorder by 17-50%. However, antiviral treatment reduces the likelihood of perinatal transmission to 2%. However, when prescribing therapy, it is necessary to take into account the course of pregnancy. HIV, as we have already described, can also be different. Factors that increase the likelihood of passing it on to the fetus are:

• late treatment when the disease has reached an advanced stage;
• infection during pregnancy;
• complicated pregnancy and difficult childbirth;
• damage to the fetal skin during childbirth.

Infection during childbirth

In fact, if you test positive for HIV during pregnancy, you may well give birth to a healthy baby. But he will be born with his mother's antibodies. This means that immediately after birth the child will also be HIV positive. But for now this only means that his body does not have its own antibodies, but only maternal ones. It will take another 1-2 years until they completely disappear from the baby’s body, and now it will be possible to say for sure whether the child has become infected.

The expectant mother should know that HIV during pregnancy can be transmitted to the baby during intrauterine development. However, the higher the mother’s immunity, the better the placenta works, that is, the organ that protects the fetus from viruses and bacteria in the maternal blood. If the placenta is inflamed or damaged, the likelihood of infection increases. This is another reason why it is necessary to undergo a thorough examination by your doctor.

But most often, infection occurs during childbirth. Therefore, pregnancy with HIV infection must be accompanied by mandatory antiviral therapy to reduce this likelihood to a minimum. The fact is that while passing through the birth canal, the baby has a high chance of coming into contact with blood, which dramatically increases the possibility of infection. If you remember from school, this is the shortest route of transmission of the virus. Caesarean section is recommended if a large number of viruses are detected in the blood.

After childbirth

As we have already said, an HIV test during pregnancy is necessary so that in case of a positive result, the mother can undergo full-fledged therapy and maintain her health. During pregnancy, physiological suppression of the immune system occurs. So while the previous study only looked at pregnancy, others have gone further and found that the development of HIV may accelerate after childbirth. Over the next two years, the disease may progress to a much more severe stage. Therefore, you cannot rely only on the desire to become a mother. Consultation with a doctor is required at the planning stage. Only this approach can become your assistant. HIV positive during pregnancy can seriously undermine health, which subsequently leads to a reduction in quality of life.

Breastfeeding and its dangers

The pregnancy of HIV-infected people can proceed very well when the baby develops normally and is born completely healthy. Of course, his blood will contain the mother’s antibodies, but they may not have an effect on the child’s immunity. However, now the mother faces a choice whether to feed her baby breast milk. The doctor must explain that breastfeeding almost doubles the risk of infection. So giving it up will be the best choice. High-quality formulas will give the baby much better chances for the future.

Your risks

There are a number of factors that may not work in your favor. This is primarily a weakening of the mother's immunity. A high, that is, a large number of viruses in a woman’s blood is also a bad sign. In this case, the doctor may suggest terminating the pregnancy. We have already talked about breastfeeding - 2/3 of all cases of infection of a child from his mother occur during the first six weeks of life. Multiple pregnancy is also a risk factor.

First of all, the expectant mother needs to register as early as possible. Be sure to follow all the recommendations of your doctor, then you will have a better chance of giving birth to a healthy baby. Starting from the 14th week, a pregnant woman can take the antiviral drug Azidothymidine or its analogue. She receives such prevention completely free of charge. If a woman, for a number of reasons, did not take it before the 34th week, then she needs to start doing so at a later date. However, the earlier treatment is started, the less chance the mother has of passing the disease on to her baby.

Treatment

HIV therapy during pregnancy requires careful consideration of the mother's condition and the duration of pregnancy. That is why leave it to an experienced doctor and under no circumstances try to self-medicate. If you consulted a specialist before pregnancy, at the time of planning it, then most likely you will be prescribed combination therapy. The decision to start it is made on the basis of two tests - the level of CD-4 cells and the viral load. Current treatment requires the simultaneous use of two or more antiviral drugs.

An HIV test (pregnancy is a reason to cancel combination therapy) is the starting test on which all further treatment is based. Only one antiviral drug is left for the expectant mother in order to prevent infection of the baby.

If a woman took combination therapy before pregnancy, then if pregnancy occurs, she is recommended to take a break for the first trimester. In this case, blood for HIV during pregnancy is taken, as a rule, three times, and in a particular case the number of samples can be increased at the discretion of the doctor. The rest of the treatment is symptomatic. This allows you to reduce the risk of developmental defects in the unborn baby, as well as avoid the dangerous state of resistance, in which the virus is no longer treatable.

What a woman should remember

Despite the fact that the achievements of modern medicine make it possible to reduce the risk of infection of a child from his own mother to 2%, it still exists. Therefore, you need to weigh the pros and cons, because a woman, even if she is HIV-infected, wants to carry and give birth to a healthy baby. The difficulty is that you will not know for a long time whether your baby was born HIV-positive, and this cannot be predicted in advance. So you have a long and tedious wait ahead of you. The ELISA will give a positive result approximately 6 months after birth, so be patient.

When deciding to give birth, a woman should know what awaits her child if he falls into this unlucky 2%. We remind you that such a minimal probability of giving birth to a baby with the immunodeficiency virus is only possible if the woman did not follow all the doctors’ recommendations, did not undergo constant examinations and did not take medications exactly according to the regimen.

HIV is most severe in those babies who are infected in utero. The symptoms in this case are much more pronounced, and often such children do not live to see one year old. A smaller number manage to experience adolescence, but their life in adulthood can only be predicted hypothetically, since so far there have been no such cases.

HIV infection during childbirth or breastfeeding is somewhat easier, because the virus affects an already formed body with a developing immune system. However, the child's life expectancy will be very limited. Usually doctors do not make a prognosis longer than 20 years.

Prevention

Congenital HIV infection means hospitals and medications from childhood. Of course, everything must be done to prevent such developments. Therefore, it is very important to carry out timely prevention of this disease. Today this work is carried out in three directions. First of all, this is HIV prevention among women of childbearing age. The second direction is the prevention of unwanted pregnancies among women with HIV. Finally, the last thing is the prevention of transmission of infection from a woman to her child.

Testing positive for HIV during pregnancy is not the end of the world. However, a woman must be aware that she has a chance to infect her baby. Modern therapy has greatly increased the life expectancy of an HIV-positive person. Many live 20 years or more after infection. However, if for an adult this is a whole life, then for a child it is a chance to meet youth and leave. Medical achievements do not relieve women of responsibility, so first of all, each of them should think about the future of their baby.

Instead of a conclusion

This is a topic that you can talk about endlessly, and there will still be a lot of unsaid. An HIV diagnosis is like a bad dream, ruining all plans for the future, but it is especially tragic to learn about your diagnosis during pregnancy. In this case, the expectant mother faces a difficult choice and enormous responsibility. Give up your baby or give birth? Will he be healthy or will he face endless treatment? All these questions do not have a clear answer. Today we gave you a brief tour and talked about the main problems associated with pregnancy in infected women.

Of course, the achievements of modern medicine have made it possible for a huge number of women to experience this. Today, people diagnosed with HIV believe that they are full members of society, have the right to a family and the birth of healthy children.