ВИЧ-ИНФЕКЦИЯ И МАТЕРИНСКАЯ СМЕРТНОСТЬ

The aim of the study is to assess the incidence and causes of maternal mortality affected by HIV infection in Saint-Petersburg.  Materials and methods . All cases of the maternal mortality were accounted from the beginning of the epidemic of HIV infection in the city. Results . In Saint Petersburg, the first case of maternal mortality due to HIV infection was registered in 2002. Through 2002 to 2015, 164 cases of maternal mortality were registered. 31 of the cases were due to HIV infection (18,98±9,4%). So the number of these cases was 31 by the end of 2015. A high incidence of HIV infection in combination with injecting drugs (67,0±8,4%) and with chronic forms of parenteral viral hepatitis (58.0±8.8%) was reported. Drug addiction associated with HIV infection induced a high incidence of the angiogenic sepsis progression, which became the most common mortality factor (in 12 out of the 31 cases). AIDS-related co-infections (generalized forms of tuberculosis, pneumocystis pneumonia) caused the death of another 12 women. The total share of the infection as the cause of maternal death was 80,6±7,2%. In most patients, combinations of various AIDS-indicative states were reported: generalized cryptococcosis, necrotic toxoplasma encephalitis, chronic isosporosis, cachexia, oropharyngeal and esophageal candidiasis and more. Liver lesions up to cirrhosis were identified in 14 cases of co-infections of HIV/HCV and HIV/HCV+B. At the same time, the effect of HIV on progression and retrogression of obstetric pathogenic behavior was not reported. Obstetric complications occurred in only two patients hospitalized with the irreversible consequences of eclampsia (stroke and abruptio placentae complicated by cortical necrosis). These pregnant women did not seek medical help until hospitalization. In summatioin, 18 women had never sought medical help during pregnancy, which indicates the importance of social factors in pregnancy and childbirth outcomes.