P226. Ultrasound parameters to evaluate HIV positive pregnant women

Alexandra Ursache (RO), Dragos Nemescu (RO), Mircea Onofriescu (RO), Alexandra Mihaila (RO), Roxana Matasariu (RO)

[Ursache] University of Medicine and Pharmacy “Grigore T. Popa”- Iasi Faculty of Medicine, [Nemescu] University of Medicine and Pharmacy “Grigore T. Popa”- Iasi Faculty of Medicine, [Onofriescu] University of Medicine and Pharmacy “Grigore T. Popa”- Iasi Faculty of Medicine, [Mihaila] Clinical Hospital of Obstetrics and Gynecology „Cuza-Voda” Iasi, [Matasariu] University of Medicine and Pharmacy “Grigore T. Popa”- Iasi Faculty of Medicine

Many HIV (Human Immunodeficiency Virus) positive women are of fertile age. The efficiency of antiretroviral treatment determined an increase in HIV positive pregnant women’s prevalence. Objectives: We evaluated HIV positive pregnant women under HAART (Highly Active Antiretroviral Therapy) therapy, trying to determine if the congenital anomaly rate is higher than in normal pregnant population, due to the antiretroviral treatment. Also we have tried to determine if prenatal screening for fetal anomalies and Doppler evaluation of uterine arteries are influenced by the HIV infection or/and by antiretroviral treatment, HIV pregnancies often being complicated with IUGR (Intrauterine Growth Restriction) or SGA (Small for Gestational Age). Methods: Our prospective study extended between January 2013 and March 2017. We have evaluated 40 HIV positive pregnant women under HAART therapy. Ultrasound examinations were performed monthly in the first two trimesters and on two weeks interval until birth (first and second trimester screening for fetal anomalies and at least 3 ultrasound examinations after 24 weeks of gestation were compulsory for the admission in this study). Results: We identified only one case with fetal anomalies, a patient with high risk of Down syndrome determined in first trimester screening for aneuploidy. If there were no complications the pregnancies were terminated by C-section at 38 weeks of gestation. 80 % of the births were at term, 20% of the patients had premature labor. From those that gave birth at 38 weeks of gestation, 20% had newborns that weighted over 3000 g, 60% under 3000 g. We mention one case where the pregnancy had to be evacuated prematurely due to maternal conditions (cerebral tumor). Conclusions: Our study didn’t reveal any association between antiretroviral treatment and fetal anomalies. Uterine artery Doppler evaluation was useful in determining the cases with high risk of developing IUGR, known to have a high incidence in HIV positive pregnancies. We have noticed a higher percentage of premature births in patients with fewer ultrasound and obstetrical examinations.