Revista Brasileira de Ginecologia e Obstetrícia (Apr 2011)
Rastreio da infecção pelo vírus da imunodeficiência humana no momento do parto Screening of infection by human immunodeficiency virus at the time of delivery
Abstract
OBJETIVO: avaliar a frequência de testes anti-HIV realizados no pré-natal e de testes rápidos solicitados para estantes internadas para o parto. MÉTODO: trata-se de um estudo de corte transversal com 711 gestantes atendidas no momento do parto no período de janeiro a julho de 2010. Excluíram-se do estudo aquelas admitidas para controle clínico e as que não permitiram que seus dados fossem incluídos na pesquisa. Utilizou-se o teste do χ² ou o teste de Fisher para comparação de proporções na análise univariada. Foram incluídas no modelo de regressão logística todas as variáveis com valor pPURPOSE: to evaluate the frequency of HIV tests performed during prenatal care and rapid tests ordered for pregnant women admitted at the time of delivery. METHOD: this was a cross-sectional study with 711 pregnant women at delivery during the period from January to July 2010. Women admitted for clinical control and those that did not allow their clinical data to be included in the study were excluded. The χ² test or the Fisher's Exact test was used for comparison of the proportion in univariate analysis. All the variables with p<0.25 were included in the logistic regression model, called initial model. The analyses were carried out using the SPSS software, with the level of significance set at 5%. RESULTS: the mean age of the patients was 25.77±6.7 years and the maximum and minimum age was 44 and 12 years, respectively. The average gestational age at the time of attendance was 38.41±6.7 weeks. Of these patients, 96.3% (n=685) had prenatal care and 11.1% (n=79) received prenatal care at our facility. The average number of prenatal care visits was 6.85±2.88, but 28.1% had less than six visits. We identified 10 HIV-positive pregnant women (1.4%) and two patients were known to be HIV positive. The others (n=8) were screened at birth and therefore did not receive ARV prophylaxis during the prenatal period. Three patients were admitted during the expulsion period and also did not receive intrapartum antibiotic prophylaxis. However, all newborns were evaluated, with lactation being suppressed and artificial milk being used. CONCLUSIONS: despite the measures established by the Ministry of Health, there are still flaws in the approach to these patients. Only with the participation of managers and professionals involved in care it will be possible to correct the direct actions that enable the effective prevention of vertical transmission of HIV.
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