[AIDS and the fetus]

Abstract

Acquired immunodeficiency syndrome has become a major problem in women and children in European countries. The most frequent cause of contamination is intravenous drug abuse but heterosexual transmission appears to be more and more frequent. If the mother is seropositive, the proportion of contaminated infants is about 30% to 40%. Half of them develop AIDS within three years and nearly all of them have some clinical manifestations within five years. Numerous data provide clear evidence of transplacental transmission but the possibility of intrapartum transmission cannot be excluded. The procedures adopted by most obstetricians is discussed: abortion during first trimester and sometimes second trimester of pregnancy, spontaneous delivery or cesarean section. Breast milk has been implicated as a transmission mode for HIV so in Europe it is recommended that seropositive mothers not breast-feed. In the absence of a vaccine or effective therapy, the author insists on preventive measures. Further research is needed to delineate the route of perinatal transmission, the part of prenatal diagnosis and the effect of treatment with antiviral agents.