An Audit of Perineal Trauma and Vertical Transmisson Of HIV

Amaka N. Ocheke, Ephraim Samuels, Isaac E. Ocheke, Patricia A. Agaba, Clement Ekere, James Bitrus, Emmanuel I. Agaba, Atiene S. Sagay

Abstract

Restrictive episiotomy is recommended for the prevention of vertical transmission of HIV. The study compared the frequency of episiotomy use and the occurrence of perineal tears; and related factors in HIV positive and HIV negative women and to assess their effect on Mother-to-child transmission (MTCT) of HIV. A total of 110 HIV positive and 134 HIV negative parturients were enrolled in the study. The incidence of episiotomy was more in the HIV negative group (p=0.0000) while that of perineal tear was not affected by HIV status (p=0.17). The rate of episiotomy was significantly affected by primigravidity in HIV negative subjects (OR= 0.032, 95% CI 0.0072-0.13). The rate of perineal tear was significantly affected by primigravidity in HIV positive subjects (OR=8.55, 95% CI 1.91-38.7) and multigravidity in HIV negative subjects (OR= 0.030, 95% CI 0.133-0.71). Gestational age and mean birth weight had no effect on the rate of episiotomy (p value =0.57 and 0.30) and perineal tear (p value= 0.79 and 0.061). There was no mother-to-child HIV transmission. Episiotomies should be given when needed irrespective of HIV status because of the risk of consequent perineal tear and with HAART the risk of MTCT from perineal trauma is minimal. (Afr J Reprod Health 2017; 21[4]: 67-72).

Full Text:

PDF

References

HIV/AIDS. Centers for Disease Control.

http://www.cdc.gov/hiv/basics/index.html

(Accessed July 7, 2014)

Mandelbrot L, Mayaux MJ, Bongain A, Berrebi A,

Moudoub-Jeanpetit Y, Bénifla JL, Ciraru-Vigneron

N, Le Chenadec J, Blanche S and Delfraissy JF.

Obstetric factors and mother-to-child transmission

of human immunodeficiency virus type1: The

French perinatal cohorts. Am J Obstet Gynecol.

; 175: 661-667

Kourtis AP, Bulterys M. Mother-to-Child Transmission

of HIV: Pathogenesis, Mechanisms and Pathways.

Clin Perinatol. 2010: 37; 721–737

Gray GE, McIntyre JA. HIV and pregnancy. BMJ. 2007;

: 950-953

Alayande BT, Amole IO andOlaolorun DA. Relative frequency and predictors of episiotomy in

Ogbomosho, Nigeria. Internet Journal of Medical

Update. 2012;7: 42-45

Mutihir JT, Ujah IOA. Episiotomies in the Jos University

Teaching Hospital. Highland Medical Research

Journal. 2005;3: 31-35

Onah HE, Obi SN, Agbata TA and Oguanuo TC.

Pregnancy outcome in HIV-positive women in

Enugu, Nigeria. J Obstet Gynecol. 2007;27: 271-

Sule ST, Shittu SO. Puerperal complications of

episiotomies at Ahmadu Bello University Teaching

Hospital, Zaria, Nigeria. East Afr Med J. 2003;

:351-356

Carroli G, Mignini L. Episiotomy for vaginal birth

(Review). The Cochrane Collaboration. JohnWiley

& Sons, Ltd; 2012

Volmink J, Siegfried N, van der Merwe L and

Brocklehurst P. Antiretrovirals for reducing the risk

of mother-to-child transmission of HIV infection.

Cochrane Database Syst Rev 2007; 1:CD003510.

Ocheke AN, Agaba PA, Imade GE, Silas OA,

Ajetunmobi OI, Echejoh G, Ekere C, Sendeht A,

Bitrus J, Agaba EIand Sagay AS. Chorioamnionitis

in pregnancy: a comparative study of HIV- positive

and HIV-negative parturients. Int J STD AIDS.2015;

(0):1-9. DOI:10.1177/0956462415580887

Azria E, Kane A, Tsatsaris V, Schmitz T, Launay O and

Goffinet F. Term labor management and outcomes

in treated HIV-infected women without

contraindications to vaginal delivery and matched

controls. Int J Gynaecol Obstet. 2010; 111:161-164.

He´man LM, van der Linden PJQ andStigter RH.

Attitude of Maternity Staff Regarding Episiotomies

in an African Rural Hospital with High HIV

Prevalence: A Descriptive Qualitative Study. Am. J.

Trop. Med. Hyg.2014; 90: 976–979

Nuwagaba-Biribonwoha H, Mayon-White RT, Okong P,

Mwebaze EB, Kalanzi H, Kiyingi A, Brocklehurst P

and Carpenter LM. The impact of the prevention of

mother-to-child HIV transmission (PMTCT)

programme on intrapartum obstetric practices in

Uganda. Poster Exhibition: The 3rd IAS Conference

on HIV Pathogenesis and Treatment: Abstract no.

MoPe11.7C02".

Elie N, Luc K. Episiotomies during deliveries of

singletons in cephalic presentation: The incidence

can be reduced. J Obstet Gynecol India. 2012: 62:

-643

Sooklim R, Thinkhamrop J, Lumbiganon P,

Prasertcharoensuk W, Pattamadilok J, Seekorn K,

Chongsomchai C, Pitak P and Chansamak S. The

outcomes of midline versus medio-lateral

episiotomy. Reprod Health. 2007; 4:10.

doi: 10.1186/1742-4755-4-10

Boer K, Nellen JF, Patel D, Timmermans S, Tempelman

C, Wibaut M, Sluman MA, van der Ende ME

andGodfried MH. The AmRo study: pregnancy

outcome in HIV-1-infected women under effective

highly active antiretroviral therapy and a policy of

vaginal delivery. BJOG. 2007;114:148-55.

Islam S, Oon V, Thomas P. Outcome of pregnancy in

HIV-positive women planned for vaginal delivery

under effective antiretroviral therapy. J Obstet

Gynaecol. 2010 ;30:38-40. doi:

3109/01443610903383358.

Refbacks

  • There are currently no refbacks.