“Manejo de mujer gestante serodiscordante en segundo nivel de atención

Abstract

This case involves a female patient, 31 years old, whose husband was diagnosed as HIV positive, 3 years ago. Patient had arrived at the clinic where she has presented with 2 months of amenorrhea. A medical evaluation is performed without alteration of vital signs, in addition, a (β-hCG) blood examination is preformed where pregnancy is confirmed. This pregnancy is cataloged as high risk. Patient was explained the various options available at the clinic, as well as the associated risks and advantages that a HIV positive pregnancy can have when both parents are HIV positive. This is explained by medical personnel at the clinic. Patient is referred to a higher level of care requiring additional attention where she will have routine exams, serological and imaging. The specialist once again explains the risks and advantages that this pregnancy will have when both parents are positive, thus with this, information is gathered in regards to the diagnosing and treatment needed in these cases.

During the second month check-in where antiretrovirals were administered, patient came to the clinic complaining of continuous abdominal pain located in the mesogastrium region. Patient claimed that the pain was caused by the antiretroviral

treatment. The treatment is then stopped. After months of gestation, patient arrives to the clinic presenting with abdominal pain that has been occurring for 8 hours, located in the hypogastrium region. This is a high intensity contraction. Upon physical examination: pregnant uterus, single fetus, alive, cephalic, right lateral dorsum; tocopography: FCF 130 x´, AU 4/10 '/ 45''. Upon vaginal examination it is discovered that patient is dilated to 9 cm, effacement 90%, with bulging membranes. Patient decides to check into the obstetrics clinic to labor and deliver where male baby is born, full term, with an APGAR score of 7-9, weight is adequate for gestational age. This all occurred during 32 hours, no complications and patient was sent home.