Documente Academic
Documente Profesional
Documente Cultură
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PREVENTION OF MATERNAL
TO CHILD TRANSMISSION OF
HIV
International
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Objectives
International
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Introduction
International
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International
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International
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International
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Maternal to Child
Transmission
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Viral factors:
(Load,strain variation)*
Maternal: CD4 count
STD infections*
Substance abuse
Sexual behavior*
Placental disruption
Preterm deliveries
Duration of membrane
rupture.*
Invasive procedure in
Labour( Instrumental
vaginal
deliveries,episiotomies*
Mode of delivery
Fetal/neonatal factors
Breast feeding *
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Prevention of Maternal to
Child Transmission
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Comprehensive ANC
minimum package for PMTCT
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Early Attendance
Refocused ANC with at least 4 to 5 visits
Detailed history taking
Examination to rule out signs of HIV related illness
Baseline Investigation: Hemoglobin,RPR for
syphilis,Urine analysis
Voluntary confidential counseling and testing.
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International
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Health education
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ANC-4
1.Micro-nutrient supplements
2.Prevention & treatment of infections
Intermittent presumptive treatment: 3 doses
of SP
identification& treatment of STI
3.Anti retroviral treatment
AZT
Neverapine
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Delay ARM
ECV
Routine episiotomies
Instrumental deliveries
Traumatic suction of child
Universal precautions.
4. Mode of delivery
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Options:
AZT after 36 weeks antepartum,intrapartum
amd post partum with neonatal treatment for
7 days. (%Reduction 50%) at 8weeks
Nevirapine In labour and neonatal treatment
for 48 to 72 hours. (% reduction 47%) at 8
weeks
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Antepartum
Intrapartum
Post partum
For mother
neonatal
1.AZT 300mgs
p.o B.D after 35
weeksgestation
2.
None
none
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Conclusion