- Preventing Mother-to-Child transmission of HIV-

Guidelines Address HIV Testing, Prophylaxis to Mother-to-Child Transmission

Below I am quoting some of the guidelines for dealing with Pregnancy in High HIV risk pregnancies, during and after labour.
You can view all the guidelines here

• When the mother's HIV serostatus is unknown, the newborn infant's healthcare professional should order rapid HIV antibody testing for the mother or the newborn, with appropriate consent as required by state or local law.
• To facilitate appropriate care and testing of the newborn infant, maternal HIV serostatus should promptly be disclosed to the healthcare professional for that infant.
• When results of HIV rapid antibody test are positive, the mother and newborn infant should receive antiretroviral prophylaxis without waiting for results of confirmatory HIV testing.
• Although women with positive results of HIV rapid antibody test should not breast-feed, they should be offered assistance with immediate initiation of hand and pump expression to stimulate milk production, in the event that confirmatory test results may be negative. If this proves to be the case, prophylaxis should be stopped and breast-feeding may be started.
• All facilities with an obstetric unit and/or newborn nursery of any level should have rapid HIV antibody testing available on a 24-hour basis.
• Infant medical records should document maternal HIV-infection status, and this documentation should be a standard measure of the adequacy of hospital care for the mother and infant.
• Although prophylaxis is most effective within 12 hours of birth, it may still be effective when started as late as 48 hours of life.
• Before hospital discharge, the full 6-week course of infant antiretroviral prophylaxis should be arranged and the family should be carefully instructed regarding administration. All third-party payers should pay for the prophylaxis.
• Infants should not breast-feed if either the mother or the infant has a positive test result for HIV antibody.
• The newborn infant should be tested for HIV antibody, preferably within the first 12 hours of life, in the absence of parental availability for consent. State and local jurisdictions should develop policies to ensure rapid assessment and testing of the infant.
• To guide appropriate care and follow-up testing if indicated, infants of unknown HIV exposure status at the first health supervision visit should undergo HIV antibody testing with appropriate consent.
• Specialists in obstetric and pediatric HIV infection should be consulted regarding care of the mother, fetus, newborn, and child with perinatal exposure to HIV.