OBJECTIVE: We sought to describe rates of and risk factors for complications by delivery mode among human immunodeficiency virus-infected women with CD4 counts of <; or = 500/microL. STUDY DESIGN:Complication rates were calculated by delivery mode, as follows: planned cesarean delivery performed without labor or rupture of membranes, other cesarean delivery performed after labor or rupture of membranes, or vaginal delivery. Risk factors were evaluated. RESULTS: Major complications in the planned cesarean delivery (n = 37), other cesarean delivery (n = 95), and vaginal delivery (n = 365) groups were amnionitis or endometritis (16%, 27%, and 7%, respectively), wound infection (5%, 8%, and <1%, respectively), and transfusion (8%, 6%, and 3%, respectively). Any peripartum infection occurred among 16 (18%) of those with a CD4 count of <200/microL and 43 (13%) with a CD4 count of > or =200/microL (P =.17). On multivariate analyses, factors associated with amnionitis-endometritis were cesarean delivery and African American race, and a factor associated with transfusion was third-trimester anemia. CONCLUSION:Endometritis and wound infection occurred more frequently among human immunodeficiency virus-infected women after cesarean than among women undergoing vaginal delivery; however, complication rates overall were within the range reported in human immunodeficiency virus-negative women. Measures to decrease complications in human immunodeficiency virus-infected women, such as greater use of prophylactic antibiotics, should be assessed.
RCT Entities:
OBJECTIVE: We sought to describe rates of and risk factors for complications by delivery mode among human immunodeficiency virus-infectedwomen with CD4 counts of < or = 500/microL. STUDY DESIGN: Complication rates were calculated by delivery mode, as follows: planned cesarean delivery performed without labor or rupture of membranes, other cesarean delivery performed after labor or rupture of membranes, or vaginal delivery. Risk factors were evaluated. RESULTS: Major complications in the planned cesarean delivery (n = 37), other cesarean delivery (n = 95), and vaginal delivery (n = 365) groups were amnionitis or endometritis (16%, 27%, and 7%, respectively), wound infection (5%, 8%, and <1%, respectively), and transfusion (8%, 6%, and 3%, respectively). Any peripartum infection occurred among 16 (18%) of those with a CD4 count of <200/microL and 43 (13%) with a CD4 count of > or =200/microL (P =.17). On multivariate analyses, factors associated with amnionitis-endometritis were cesarean delivery and African American race, and a factor associated with transfusion was third-trimester anemia. CONCLUSION:Endometritis and wound infection occurred more frequently among human immunodeficiency virus-infectedwomen after cesarean than among women undergoing vaginal delivery; however, complication rates overall were within the range reported in human immunodeficiency virus-negative women. Measures to decrease complications in human immunodeficiency virus-infectedwomen, such as greater use of prophylactic antibiotics, should be assessed.
Authors: S Grignolo; R Agnello; D Gerbaldo; C Gotta; C Alicino; F Del Puente; L Taramasso; B Bruzzone; C Gustavino; S Trasino; A DE Maria; G Icardi; C Viscoli; A DI Biagio Journal: Epidemiol Infect Date: 2017-03-22 Impact factor: 4.434
Authors: Erin M Macdonald; Ryan Ng; Mark H Yudin; Ahmed M Bayoumi; Mona Loutfy; Janet Raboud; Khatundi-Irene Masinde; Wangari E Tharao; Jason Brophy; Richard H Glazier; Tony Antoniou Journal: AIDS Res Hum Retroviruses Date: 2015-07-28 Impact factor: 2.205
Authors: Helen Cavasin; Thao Dola; Olga Uribe; Manoj Biswas; Mai Do; Azad Bhuiyan; MarkAlain Dery; Chi Dola Journal: Infect Dis Obstet Gynecol Date: 2009-05-25