infant, see Section I

Version 6/13/2014 UTMB Protocol for Management of HIV-Infected Pregnant Women and Newborns (For management of ‘Indeterminate’ woman/infant, see Secti...
Author: Amos Wilkinson
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Version 6/13/2014

UTMB Protocol for Management of HIV-Infected Pregnant Women and Newborns (For management of ‘Indeterminate’ woman/infant, see Section I.) A. Identification/Referral by Obstetrics Providers: 1. As per the Texas state law (Texas Health and Safety Code 81.090, and Texas Administrative Code, Rule 97.135), all pregnant women will be counseled and offered testing for HIV at the very first contact with a clinician (inpatient or outpatient), and at third trimester (32 weeks gestation). For additional information on HIV testing at delivery see Section G. 2. Review HIV results in a timely fashion. 3. Review positive results with the patient. 4. Refer all women to Maternal Child HIV Clinic: Call 409-772-1459 or 409-772-2798 for appointment, and FAX clinical and laboratory information to 409-747-1753. 5. If women are hospitalized during pregnancy or labor, please call the Pediatric Infectious Disease Faculty On-Call through UTMB page operator: 409-772-1011 for inpatient consult. 6. As with any other abnormal critical lab test, the follow up of patients with positive results must be confirmed and documented. B. Evaluation by Maternal Fetal Medicine OBGYN during pregnancy: 1. Discuss and begin treatment (see treatment options in Section D) 2. Discuss delivery options:  Unlike previous studies of monotherapy with zidovudine (ZDV, also known as AZT) which showed an additional benefit of elective Caesarian section delivery, recent data show that pregnant women treated with 3-drug combinations have a very low risk of perinatal HIV transmission (