Pregnancy and HIV disease
Issues that positive women may face when they're pregnant
August 2005 View PDF En
español
Medications and procedures to consider
during pregnancy
There are several prenatal procedures and medications that can
harm the mother and/or the baby’s development. It’s
important to work closely with your doctor to carefully weigh the
risks and the benefits. In addition, certain health and nutrition
issues are important to consider.
The following tests should be avoided unless
they're essential:
- Amniocentesis tests for genetic defects
in the baby. This is done with a needle inserted through the mother’s
abdomen and into her uterus.
- CVS (chorionic villus sampling) tests for
genetic abnormalities in the baby and for inherited disorders. This
is done by inserting a speculum into the uterus and taking a small
sample from the forming placenta.
- Cordocentesis or fetal blood sampling (FBS)—also
known as PUBS (percutaneous umbilical blood sampling)—is a
procedure that removes a small amount of blood from the fetus during
pregnancy. FBS is performed to diagnose, treat and monitor various
fetal problems such severe fetal anemia, genetic or chromosome abnormalities,
fetal infections, or to give certain medications to the fetus. Fetal
scalp sampling is another type of procedure used for similar reasons
when a small amount of blood is taken from the infants scalp during
labor.
- Internal fetal and labor monitoring (external
fetal monitoring such as ultrasound is safe).
Health and nutrition
- uncooked or undercooked meat,
- cat feces, cat litter and soil that contains cat
feces,
- unpasteurized dairy products, and
- hot tubs, saunas, or exposure to illnesses that
can cause fevers or high body temperatures.
- Cut back on caffeine (including coffee,
tea, soft drinks, and herbal products that contain caffeine).
Medications for treating HIV disease
The following is a list of medications used to treat HIV
and common HIV-related illnesses that should be used with caution
or not used at all during pregnancy.
The following anti-HIV drugs are contraindicated
for use during pregnancy:
Efavirenz (Sustiva)
Efavirenz can cause brain damage to the infant. It should
not be used at all during pregnancy and should be stopped immediately
if you plan to get pregnant or find out that you are pregnant.
Hydroxyurea
This drug is not commonly used to treat HIV anymore. However,
it should not be used during pregnancy or by the man while trying
to conceive.
ddI (Videx) and d4T (Zerit)
When these drugs are used together, they can cause excess
lactate leading to potential liver damage (lactic acidosis). This
risk is increased in pregnant women. This can be dangerous for both
the mother and the developing baby, so they should not be used during
pregnancy.
Liquid form of amprenavir (Agenerase)
One of the components of this form of Agenerase is unable
to be broken down by pregnant women and young children. Agenerase
in capsule form is safe to take.
The following anti-HIV drugs can be used if and
when the benefits outweigh the risks. However, close monitoring
is recommended.
Atazanavir and indinavir
Atazanavir (Reyataz) and indinavir (Crixivan) can increase levels
of bilirubin (a chemical produced in the liver). Serious elevations
can cause liver dysfunction, which can impact both the mother and
baby. These drugs can be used during pregnancy, but extra monitoring
may be needed. If you have hepatitis C or any other liver problems,
talk with your doctor about taking these protease inhibitors.
Protease inhibitors
Protease inhibitors and pregnancy have both been associated with
diabetes and/or elevated glucose levels. If you take protease inhibitors
during your pregnancy, make sure your doctor closely checks your
glucose levels.
Medications for opportunistic infections
and other illnesses
The following medicines are contraindicated for use during pregnancy:
Azole drugs
Azole drugs (such as fluconazole or itraconazole) are used
to treat and prevent yeast/fungal infections and thrush. They potentially
cause birth defects and should not be taken orally. It is very common
for pregnant women to get yeast infections, so talk with your doctor
about topical options for prevention and treatment.
Intravaginal 5-fluorouracil
Intravaginal 5-fluorouracil (5-FU) is used to treat cervical
dysplasia (abnormal cells in, on and/or around the cervix, most
commonly caused by human papillomavirus) is not recommended during
pregnancy.
Live vaccines
Live vaccines including measles, mumps and rubella should
not be used during pregnancy.
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