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Ginekologia i Położnictwo medical project
ISSN 1896-3315 e-ISSN 1898-0759

The cost-effectiveness of elective cesarean delivery in prevention of perinatal transmission HIV and HSV infections


Abstract

Author(s): ZBIGNIEW SŁOMKO, KRZYSZTOF DREWS, AGNIESZKA SEREMAK-MROZIKIEWICZ, TOMASZ ŁUKASZEWSKI

This article concerns of health consequences and cost-effectiveness of delivery strategies in the group of pregnant women with detectable HIV RNA or HSV DNA. The cost-effectiveness analysis was carried out by probabilistic decision model. Two delivery strategies were compared: elective cesarean section and vaginal delivery. Elective cesarean section is a cost-effective method to prevent vertical transmission of HIV among women receiving antiretroviral therapy. Although the cost-effectiveness of delivery strategy is dependent on the severity of HIV infection. The highest risk of the vertical HSV transmission occurs during the maternal active genital herpes infection at labour. Therefore, prevention of HSV infection in late pregnancy is the best way to reduce maternal-fetal transmission of herpes virus. Numerous studies suggest that caesarean section could reduce transmission of neonatal herpes, and should be performed among the group of labouring women with active herpes infection