艾滋病阳性孕妇47例妊娠结局分析

目的探索适合东莞市市情的艾滋病母婴垂直传播阻断模式。方法 收集和整理2007年4月至2010年3月开展预防艾滋病母婴垂直传播工作后全市孕妇自愿接受艾滋病检测的资料,并对确诊患者47例的妊娠结局进行总结分析。结果 3年来自愿接受艾滋病检测率达90%以上,确诊HIV孕妇47例中34例选择终止妊娠,13例选择继续妊娠,这13例全部规范应用抗病毒干预并择期行剖宫产加人工喂养,4例新生儿死亡,9例新生儿中12个月艾滋病抗体检测均为阴性。8例新生儿18个月艾滋病抗体检测均为阴性;1例未满18个月未检测,3年来母婴垂直传播率〈2%。47例中在镇区级医院28例均终止妊娠,在市级医院处理的19例中,仅6例终止妊娠,13例继续妊娠,比较镇区级和市级医院终止妊娠率和继续妊娠率有显著差异（P〈0.001）。结论孕妇学校健康教育＋产科干预＋抗病毒药物干预＋人工喂养可以有效阻断艾滋病母婴垂直传播,根据孕妇不同意愿选择不同级别医院诊治可以最大限度满足孕妇做母亲的愿望。

Analysis of pregnancy outcomes of 47 HIV-positive pregnant women

Objective To explore the blocking mode for the prevention of Mother-to-child vertical transmission of AIDS in Dongguan. Methods 47 pregnant women who voluntarily accept AIDS antibody detection were detected and the diagnosis were positive after accepting the health education about AIDS for blocking Mother-to-child vertical transmission during April 2007 and March 2010. Results The rates of these people voluntarily accepting AIDS antibody detection were more than 90%. During the 47 examples,34 cases chose induced labor.13 cases chose to continue pregnancy, who received proper use of compositive treatment with anti-virus therapy and selective cesarean, artificial feeding. 4 neonates dead, the result of 9 neonatels who accepted AIDS antibody detection was negative during 12 months. The result of 8 neonates who accepted AIDS antibody detection was negative during 18 months.1 neonate didn＇t detecte because of less than 18 months. The rates of Mother-to-child vertical transmission were less than 2% in three years. During the 47 cases in the township level hospital, there were 28 cases all choose to terminate pregnancy.While in the 19 examples dealed by city level hospital,there were only 6 cases choose to terminate pregnancy,and 13 cases made the decisions to continue pregnancy.There were great differences by comparing the rates about termination of pregnancy and continuation of pregnancy between township level hospital and city level hospital（P0.001）. Conclusion These measures can block the Mother-to-child vertical transmission of AIDS effectively, including the health education in the schools for the pregnant women, the intervention of obstetrics and antiviral drugs,and artifical feeding.What＇s more,according to the different willingness of the pregnant women,to choose different level hospital to make diagnosis and get treatment can satisfy the willingness of these pregnant women to be mothers as much as possible.