Morbidade febril puerperal em pacientes infectadas pelo HIV

purpose: the morbidity in hiv-positive patients due to puerperal fever was studied and correlated to the method and duration of labor, the duration of premature rupture of the membranes, cd4+ cell count and the viral load (vl) at peridelivery. methods: a total of 207 hiv-positive women with prenatal examinations and deliveries between may 1997 and december 2001 were enrolled. of these, 32 had natural childbirth and 175 had a cesarean section. of the total of enrolled patients, 62.8% were submitted to elective cesarean section. the average age of the group was 27.4 years, and 25.6% were nulliparous and 26% were primiparous. at the moment of the delivery the average gestational age was 37.8 weeks. at the end of pregnancy the average of the cd4+ cell count was approximately 481 cells/mm3 and the viral load 49,100 copies/ml. results: puerperal morbidity occurred in 34 patients, with 33 after cesarean section and one after natural childbirth. the most usual intercurrent post-cesarean infection was that of the surgical wound (13% of the infection cases). analyzed factors, such as delivery duration, duration of rupture of the membranes, number of cd4+ cells or the viral load at peridelivery, did not interfere in puerperal morbidity. conclusions: puerperal morbidity was 16.8% and occurred more frequently after cesarean sections (18.9%) than after vaginal deliveries (3.1%). the other factors did not present a significant effect on puerperal morbidity.