AIDSWEEKLY Plus; Monday, September 17 & 24, 2001
Michael Greer, Staff Medical Writer

NewsRx - Women infected with HIV can undergo cesarean sections without an undue risk of severe complications, researchers in South Africa report.

H.S. Cronje and colleagues at the University of the Orange Free State in Bloemfontein conducted a study to "document complications associated with cesarean section in HIV infected women." Their results were published in the International Journal of Gynecology and Obstetrics.

Although the incidence of postoperative morbidity was somewhat higher for HIV positive women, Cronje and coauthors found that the severity of these complications was similar for mothers regardless of their infection status.

The researchers found a significantly higher rate of endometritis following cesarean sections in women infected with HIV. Almost a quarter (24%) of the seropositive study participants developed this inflammatory condition after surgery, compared with only 7% of HIV negative mothers. The rate of postoperative endometritis was even higher (44%) for infected women with severely compromised immune systems (CD4 cell counts <400), study data showed.

However, seropositive women who suffered from endometritis after surgery did not need extra treatment compared with HIV negative mothers, according to the report. The overall incidence of postoperative morbidity and mortality was similar for both groups of women, and HIV positive mothers did not require additional hospitalization compared with their healthy counterparts.

Neonatal birthweights were also comparable for infected and noninfected women ("Complications associated with cesarean section in HIV infected patients," Int J Gynaecol Obstet 2001 Jul;74(1):9-15.

"HIV infected patients undergoing cesarean section are at increased risk for post-operative endometritis, but the severity of the infection is not different from that in HIV negative patients," Cronje and colleagues concluded.

The corresponding author for this report is H.S. Cronje, University of the Orange Free State, School of Medicine, Dept. of Obstetrics and Gynecology, Bloemfontein 9300, South Africa.

Key points reported in this study include:

• Women infected with HIV can undergo cesarean sections without undue risk of severe complications
  


• Seropositive women did have a higher rate of postoperative endometritis, especially those with low CD4 cell counts
  


• However, these infections were no more severe than those experienced by otherwise healthy mothers after cesarean delivery
  


• The risk of all other complications was similar for women regardless of infection status
  

This article was prepared by AIDS Weekly editors from staff and other reports.

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