За годы наблюдения в Санкт-Петербурге ВИЧ-инфицированными женщинами рождено 9057 детей, 3241 из которых-за последние 5 лет. Количество родов у ВИЧ-инфицированных женщин в городе остается стабильным в течение нескольких последних лет. Несмотря на низкую частоту перинатальной передачи ВИЧ, анализ ситуации по оказанию помощи ВИЧинфицированным женщинам на этапе планирования беременности и в течение беременности позволит оптимизировать данную работу и в перспективе снизить вероятность перинатального инфицирования. Цель исследования-провести анализ оказания медицинской помощи серодискордантным парам и ВИЧ-инфицированным женщинам на этапе планирования беременности, в течение бе-ременности и родов для дальнейшего снижения частоты перинатальной передачи ВИЧ в Санкт-Петербурге. Материалы и методы Проведен проспективно-ретроспективный анализ медицинских карт 2442 беременных женщин, закончивших беременность родами в Санкт-Петербурге в 2014-2017 гг. В ходе проведения анализа оценены количество желанных беременностей в исследуемой группе, сроки постановки на диспансерный учет при беременности и начала профилактики перинатальной передачи ВИЧ, охват химиопрофилактикой при беременности, в родах и новорожденных. Статистическая обработка материала проводилась с использованием программ Exel, «Statistica 10».

Analysis of the epidemiological and demographic characteristics of HIV-infected pregnant women is important for organizing effective care for this group of patients and further reducing the frequency of mother-to-child transmission. Between 2014 and 2017 in Saint-Petersburg, there were 2524 deliveries in HIV-infected women who were observed during pregnancy, mainly in the Saint-Petersburg AIDS Center (AIDS Center). The average frequency of perinatal HIV transmission over the study period in the city was 1,3%, which is lower than the average for Russia. Out of 2524 women recently confined, 1858 HIV-infected women, who were observed during pregnancy at the AIDS Center in 2014–2017, were enrolled. Risk groups for perinatal HIV transmission in Saint-Petersburg are HIV-infected pregnant women: external or internal migrants, women with late registration at the dispensary registration for pregnancy in the antenatal clinic and the AIDS Center and, accordingly, late initiation of perinatal HIV transmission, active consumers of surfactants, pregnant women with low adherence to observation in medical institutions and to getting antiretroviral agents. The increase in coverage of the city’s population with HIV testing reveals new infections, including among women of reproductive age, as well as their partners. The timely use of ARV at the planning stage of pregnancy reduces perinatal HIV transmission and the risks of opportunistic diseases. The availability of medical care and free distribution of ARV drugs to all pregnant women who applied to the AIDS Center helps to reduce perinatal HIV transmission, including among internal and external migrants who do not have a permanent registration in Saint-Petersburg. Counseling women at the planning stage and during pregnancy by various specialists of the AIDS Center (gynecologists, infectious disease specialists, psychologists, narcologists) allows one to form a commitment to monitoring, to receiving ARV, giving up bad habits, to reduce the incidence of HIV-dissidence.

Assessing the timing and delivery methods, clinical and laboratory indicators of HIV-infected pregnant women is important for organizing effective care for this group of patients and further reducing the frequency of perinatal transmission of HIV infection. In 20142017, in Saint Petersburg, there were 2,524 childbirths in HIV-infected women, who were observed during pregnancy mainly in the Center for the Prevention and Control of AIDS and Infectious Diseases (AIDS Center). The average frequency of perinatal HIV transmission in the city over the study period was 1.3%, which is lower than the average for Russia (2.5%). A retrospective and prospective analysis of 1,858 medical records of HIV-infected women observed during pregnancy at the AIDS Center in 20142017 was performed. An annual decrease in the proportion of chronic viral hepatitis C coinfection was found, which was proportional to a decrease in parenteral HIV transmission in the study group. Due to the increase in HIV testing coverage, the frequency of detection of infections in pregnant women in antenatal clinics during registration was reduced. This allows conducting a thorough examination, counseling and a timely initiation of antiretroviral therapy (ART) during pregnancy planning. The vast majority of HIV-infected women are committed to follow-up in medical facilities during pregnancy, to receive antiretroviral prophylaxis (ARP) and, as a result, to give birth to a healthy child. The rate of preterm birth among HIV-infected women is higher than in HIV-seronegative women. This determines the timely initiation of ARP/ART during pregnancy for prevention of preterm delivery. The proportion of births through the birth canal increases annually, but the operative delivery rate remains above the population.