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(PACTG) 076 Zidovudine (ZDV) Regimen
| Time of ZDV administration |
Regimen |
| Antepartum |
Oral administration of 100 mg ZDV five times daily, initiated at 14-34 weeks' gestation and continued throughout the pregnancy. |
| Intrapartum |
During labor,intravenous administration of ZDV in a 1-hour initial dose of 2 mg/kg body weight,followed by a continuous infusion of 1 mg/kg body weight/hour until delivery. |
| Postpartum |
Oral administration of ZDV to the newborn (ZDV syrup at 2 mg/kg body weight/dose every 6 hours) for the first 6 weeks of life,beginning at 8-12 hours after birth. (Note: intravenous dosage for infants who can not tolerate oral intake is
1.5 mg/kg body weight intravenously every 6 hours.) |
ACOG Opinion on Prophylactic Scheduled Cesarean [2].
- Optimally, IV ZDV should be instituted at least 3 hours prior to surgery.
- Parturients with viral loads greater than 1000 copies/mL should be counseled regarding the potential benefit of scheduled cesarean delivery at 38 weeks.
- Data are insufficient to demonstrate a benefit for neonates of women with viral loads less than 1000 copies/mL and show no reduction in the rate of transmission if cesarean delivery is performed after the onset of labor or rupture of membranes.
- The patient's autonomy should be respected in making the final decision regarding route of delivery.
- Prophylactic antibiotics should be considered because of the increased infectious morbidity.
- Amniocentesis, application of a fetal scalp electrode, and other invasive procedures should be avoided whenever possible.
REFERENCES:
1. Public Health Service Task Force Recommendations for the Use of Antiretroviral Drugs in Pregnant Women Infected with HIV-1 for Maternal Health and for Reducing Perinatal HIV-1 Transmission in the United States
MMWR January 30, 1998 / 47(RR-2);1-30
2. ACOG Committee Opinion, Number 234, May 2000:
Scheduled Cesarean Delivery and the Prevention of Vertical Transmission of HIV Infection, American College of Obstetricians and Gynecologists. Washington, D.C.
SEE ALSO
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