Mode of delivery and HIV

Question 1

When is MOD decided in women with HIV

Answer 1

For women taking cART, a decision regarding recommended mode of delivery should be made after review of plasma viral load results at 36 weeks

Question 2

Women with a plasma viral load of

Answer 2

• In the absence of obstetric contraindications, a planned vaginal delivery is recommended
• Obstetric management in labour should follow the same guidelines as for the uninfected population

Question 3

Women with a plasma viral load of 50–399 HIV RNA copies/mL at 36 weeks

Answer 3

ELCS should be considered, taking into account the actual viral load, the trajectory of the viral load, length
of time on treatment, adherence issues, obstetric factors and the woman’s views

Question 4

Where the viral load is ≥ 400 HIV RNA copies/mL at 36 weeks

Answer 4

ELCS is recommended

Question 5

Deliver by C/S women with HIV and

Answer 5

• Except elite controllers, all HIV women taking zidovudine monotherapy irrespective of plasma viral load at the time of delivery
• All women with Viral load > 400 irrespective of whether they are on HART or not