WARD TEACHING

ON
HIV IN PREGNANCY

SUBMITTED TO SUBMITTED BY
MRS. A. ANITHA MRS. V. SANDHYARANI
LECTURER MSC(N) II YEAR
GOVT COLLEGE OF NURSING GOVT COLLEGE OF NURSING
HYDERABAD HYDERABAD
 HIV IN PREGNANCY
S SPECIFIC TIME CONTENT TAECHING/ AV AIDS EVALUATION
NO OBJECTIVES LEARNING
ACITIVITY
1 To introduce 1min INTRODUCTION: Lecturer cum Black board Group learnt
the topic Human immunodeficiency virus (HIV) is discussion
the virus that causes AIDS. When a person
becomes infected with HIV, the virus
attacks and weakens the immune system.
As the immune system weakens, the
person is at risk of getting life-threatening
infections and cancers. When that
happens, the illness is called AIDS.

HIV can be transmitted to the foetus or the

new born during pregnancy, during labour
or delivery, or by breastfeeding.
Lecturer cum OHP Known terms
To define the 1min DEFINITION: discussion
2
terms
HIV: Human immunodeficiency virus

AIDS: Acquired immunodeficiency

syndrome.
 Aids is defined as in terms of either a
CD4* T cell count below 200 cells per Ul
or the occurance of specific diseases in
association with an HIV infection

Causes Group Power point Explained

To know the 2 min • Most children with HIV get the discussion presentation causes
3
causes virus when it passes from an HIV-
positive mother to the child. This
can occur during pregnancy,
childbirth, or when breastfeeding.
• Only blood, semen, vaginal fluids,
and breast milk have been shown to
transmit infection to others.
• From mother to child during
pregnancy, delivery, or breast
feeding ( known as vertical
Power point Explained
transmission)
presentation signs and
4
To enlist the Discussion symptoms
sign and Symptoms
symptoms • Fatigue (feeling very tired)
2mins
• Fever, chills or sweating at night
(also called night sweats)
 • Enlarged lymph’s nodes (swollen
glands in the neck and groin)
• Mouth ulcers or score throat.
• Muscle aches
Chart Group known
• Rash
Lecturer cum
5 To find out the discussion
diagnostic Diagnostic Evaluation:
evaluation 1 min
All pregnant women should have a
screening test for HIV along with other
prenatal tests. Women at high risk should
be screened a second time during the third
trimester.

Mothers who have not been tested can

receive a rapid HIV test during labour.

Woman known to be HIV positive during

pregnancy will have regular blood tests,
including:

• CD4 counts
 • Viral load test, to check how much
HIV is in the blood

• A test to see if the virus will respond

to the medicines used to treat HIV
(called a resistance test)

CD4 classification system for

HIVinfection

Stage 1: CD4 count ≥ 500 cells/µl and no

AIDS defining conditions

Stage 2: CD4 count 200 to 500 cells/µl and

no AIDS defining conditions

Stage 3: CD4 count ≤ 200 cells/µl or AIDS

defining conditions

Lecturer cum Power point Group

6 10 min
To explain the discussion presentation explained
management Management

- Medical management

- Nursing management
Medical management:
HIV/AIDS is treated with antiretroviral
therapy (ART). These medicines stop the
virus from multiplying.

Treating the pregnant women:

Treating pregnant women with HIV

prevents children from becoming infected.

• If a woman tests positive during

pregnancy, she will receive ART
while pregnant. Most often she will
receive a three-drug regimen.

• The risk of these ART drugs for the

baby in the womb is low. The
mother may have another
ultrasound at the second trimester.

• HIV may be found in a woman

when she goes into labour,
particularly if she has not previously
received prenatal care. If so, she will
 be treated with antiretroviral drugs
right away. Sometimes these drugs
will be given through a vein (IV).

• If the first positive test is during

labour, receiving ART right away
during labour can reduce the rate of
infection in children to about 10%

Commonly used drugs:

- Nucleoside reverse
transcriptase inhibitors
- Nucleotide reverse
transcriptase inhibitors
Protease inhibitors
- Non-Nucleoside reverse
transcriptase inhibitors
- Entry inhibitors
Nucleoside reverse transcriptase
inhibitors
Zidovudine 600 mg
Lamivudine 150 mg
Stavudine 40 mg 
Didanosine 400 mg
Abacavir 300 mg
 Nucleotide reverse transcriptase
inhibitors Lecturer cum
Tenofovir 300 mg discussion
Protease inhibitors
Indinanir 800 mg
Ritonavir 600 mg
Entry inhibitors
Enfuvirtide 90 mg
Treating baby’s and infants

Infants born to infected mothers start

receiving ART within 6 to 12 hours after
birth. One or more antiretroviral drugs
should be continued for at least 6 weeks
after birth.
7 Discuss the Group
prognosis 2 mins discussion Hand outs Explained
Breast feeding:

HIV-positive women should not

breastfeed. This holds true even for
women who are taking HIV medicines.
Doing so may pass HIV to the baby
through breast milk.
 Nursing management:

• Preventing infection: standard

precaution
• Hand hygiene
• Personnel protective equipment’s
• Environmental control
• Respiratory hygiene
• Improving airway
• Promoting nutrition
• Controlling fatigue
• Promoting skin integrity

Prognosis:
8 Explain the 3 mins The risk of a mother transmitting HIV
prevention during pregnancy or during labour is low Lecturer cum Group
for mothers identified and treated early in discussion Black board explained
pregnancy. When treated, the chance of
her baby being infected is less than 1%.
Because of early testing and treatment,
there are fewer than 200 babies born with
HIV in the United States per year.
 If a woman's HIV status is not found until
the time of labor, proper treatment can
reduce the rate of infection in infants to
about 10%.
9 Discuss the
conclusion 1 min Children with HIV/AIDS will need to take
ART for the rest of their life. The treatment
does not cure the infection. The medicines
only work as long as they are taken every
day. With proper treatment, children with
HIV/AIDS can live a nearly normal
lifespan.

Prevention
HIV-positive women who might become
pregnant should talk to their provider
about the risk to their unborn child. They
should also discuss methods to prevent
their baby from becoming infected, such
as taking ARV during pregnancy. The
earlier the woman starts medicines, the
lower the chance of infection in the child.
Women with HIV should not breastfeed
their baby. This will help prevent passing
HIV to the infant through breast milk.

Conclusion:

All pregnant women should be offered

HIV testing and pre-test and post-test
counselling for all pregnant women.
Targeted testing of pregnant women who
report high risk behaviour not
recommended and during labour ZDV
2MG/KG IV loading dose, then
1MG/KG/HR. If ZDV not available
considered PO regimen and women who
are HIV positive should be advised to
avoid breast feeding

Bibliography:

• ‘’TEXT BOOK OF
OBSTETRICS’’ author DC
 DUTTA’S, eighth edition, Jaypee
brother’s medical publishers, page
numbers- 310-312.

• ‘’MYLES TEXT BOOK FOR

MIDWIVES’’ Jayne Marshall,
Maureen Raynor, 17th edition, page
numbers-512-514

• Obstetrics and gynaecology the

essential of clinical care, E. albert
Reece, Robert L. Barbieri. Page
numbers: 215-219.
• www.slideshare.com
 OBJECTIVES

GENERAL OBJECTIVE:

By the end of the class the students will be able to gain knowledge about ‘’ HIV in pregnancy ”

SPECIFIC OBJECTIVES:

By the end of the group will be able to

➢ define the HIV& AIDS

➢ Enlist the causes of HIV mother
➢ Discuss the signs and symptoms
➢ Find out the diagnostic evaluation
➢ Explain the management
➢ Describe the prognosis of HIV mother
➢ Explain the prevention of HIV mother
➢ discuss the conclusion