20.3
Reduce obstetric risk of HIV transmission
Clinical HIV Guidelines, 5th Edition, 2022. Chapter 20, Management of labour and delivery.
Clinical description
- Use a partograph to allow early detection and management of prolonged labour.
- Artificial rupture of membranes (ARM) increases the risk of HIV transmission.
o ARM is not indicated if labour is progressing well.
o If prolonged labour due to poor uterine contraction: perform ARM at ≥6cm cervical dilation and augment with oxytocin (Pitocin).
- Do not perform routine episiotomy except for specific obstetric indications (e.g., vacuum
extraction).
- Avoid frequent vaginal examinations.
- Do not ‘milk’ the umbilical cord before cutting.
- Do not suction a new-born with a naso-gastric tube unless there is meconium-stained liquor.
- Immediately after birth, wipe the new-born dry with a towel to remove maternal body fluids.
106 Newborn care and postnatal follow up
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