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Therapeutics
Delivery by elective caesarean section reduced vertical transmission of HIV-1 infection

https://doi.org/10.1136/ebm.4.6.178

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    The European Mode of Delivery Collaboration. Elective caesarean-section versus vaginal delivery in prevention of vertical HIV-1 transmission: a randomised clinical trial. Lancet. 1999 Mar 27;353:1035-9.

    Intervention

    Women were allocated to elective c-section at 38 weeks of gestation (n = 201) or to vaginal delivery (n = 235).

    Main outcome measures

    HIV-1 infection status in study infants confirmed by detection of virus (culture or polymerase chain reaction) on 2 separate specimens, persistence of antibody to HIV-1 beyond 18 months of age, or development of AIDS or death from an HIV-1­related cause.

    Main results

    Analysis was by intention to treat and by actual method of delivery. Of the 188 women allocated to c-section who had liveborn infants, 22 (12%) gave birth vaginally; of the 220 women allocated to vaginal delivery who had liveborn in-fants, 59 (27%) had a c-section. …

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