Abstract

AIDS: The Public Health Service has published recommendations for the use of antiretroviral therapy in HIV-positive pregnant women, although there is still controversy about the effects on the fetus. The rate of vertical transmission (mother to child transmission) is related to the mother's immune system, and is influenced by CD4 counts, viral load, the presence of p24 antigens, and the mother's ability to produce a neutralizing antibody. Some obstetrical factors may increase the risk of transmission ¿ amniocentesis, chorionic villus sampling, fetal scalp sampling, and internal fetal and labor monitoring. Cesarean sections may have a protective effect, although HIV-positive mothers are at an increased risk for post-operative complications. Results of several studies related to the effectiveness and risks of AZT are included, and a table lists the ongoing clinical trials of vertical transmission prophylaxis.