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Successful management of prenatal hydrops fetalis in a mother with HIV
James Davis1, J J Rufus Fernando
1Department of Feto-Maternal Medicine, The Birmingham Womens Hospital NHS Trust, Edgbaston, Birmingham B15 2TG, UK.
The incidence of human immunodeficiency virus (HIV) in pregnancy worldwide is increasing. We have more invasive diagnostic and therapeutic abilities in feto-maternal medicine, creating a dilemma in our management of these pregnancies. Do we aggressively manage them with the risks of vertical transmission or do we try to avoid invasive interventions? In this case, the fetus of a 36-year-old immigrant with HIV is diagnosed with hydrops fetalis. The patient's viral load was 5800 copies/mL, therefore, early intervention was unwise. Optimal HIV management, combined with referral to a specialist feto-maternal medicine unit, regular ultrasound scans and insertion of a pleuroamniotic shunt when the viral load was low, resulted in the delivery of an HIV-negative baby with excellent outcome for both mother and baby.
The incidence of human immunodeficiency virus (HIV) in pregnancy worldwide is increasing. We have more invasive diagnostic and therapeutic abilities in feto-maternal medicine, creating a dilemma in our management of these pregnancies. Do we aggressively manage them with the risks of vertical transmission or do we try to avoid invasive interventions? In this case, the fetus of a 36-year-old immigrant with HIV is diagnosed with hydrops fetalis. The patient's viral load was 5800 copies/mL, therefore, early intervention was unwise. Optimal HIV management, combined with referral to a specialist feto-maternal medicine unit, regular ultrasound scans and insertion of a pleuroamniotic shunt when the viral load was low, resulted in the delivery of an HIV-negative baby with excellent outcome for both mother and baby.
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