Publications & Reports

An audit of obstetricians' management of women potentially infected with blood-borne viruses.

Giles ML, Sasadeusz JJ, Garland SM, Grover SR, Hellard ME
Clinical Microbiology and Infectious Disease, Royal Women's Hospital, 132 Grattan Street, Parkville, Victoria 3050, Australia. michelle.giles@rwh.org.au

Abstract

OBJECTIVE: To assess obstetricians' current antenatal screening practices for blood-borne viruses (hepatitis B, hepatitis C and HIV) and how they manage pregnant women infected with a blood-borne virus.

DESIGN AND PARTICIPANTS: National cross-sectional survey conducted between September 2002 and January 2003. All obstetricians (n = 767) registered with the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) were mailed a questionnaire assessing their antenatal screening practices and knowledge of management of women potentially infected with a blood-borne virus.

OUTCOME MEASURES: Concordance of clinical practice with RANZCOG recommendations and current evidence-based guidelines.

RESULTS: 523 obstetricians (68% response rate) completed the questionnaire. Fifty-one per cent of respondents said they would always offer HIV screening and 60% would always offer HCV screening. For HIV-infected women, 36% of obstetricians would always recommend elective caesarean section and 33% would always avoid rupture of membranes. Despite a lack of evidence, 34% of obstetricians advise patients that the risk of HBV transmission is increased with breastfeeding, and 47% give the same advice about HCV transmission.

CONCLUSION: There is some discordance between the RANZCOG antenatal screening recommendations for HCV and HIV and current practice. Knowledge about the management of HIV-infected women could be improved, and more obstetricians need to be aware that current evidence suggests there is no increased risk of transmission of HBV or HCV with breastfeeding.

Publication

  • Journal: The Medical journal of Australia
  • Published: 05/04/2004
  • Volume: 180
  • Issue: 7
  • Pagination: 328-332

Author