Sepsis in a Seropositive Pregnant Woman With Early Preterm Labor Pains: A Case Study of a Near Miss

HIV is linked to a higher risk of preterm delivery in pregnant women. A systemic response to HIV virus can lead to foetus death along with patient death. Mortality is reduced in pregnant females and neonates by some interventions done carefully like antiretroviral therapy and prophylaxis, careful delivery methods, and monitoring of safe breastfeeding. Precautions are also used to decrease the mother-to-child transmission of HIV. An HIV-positive pregnant woman with sepsis is presented here to highlight the management of sepsis and labour. An HIV-positive primigravida on regular tenofovir, lamivudine, and efavirenz (TLE) regimen presented at 29 weeks and five days of her pregnancy to our outpatient department (OPD) with complaints of thick pus-like discharge and fever from seven to eight days. To manage it, labour was augmented by oxytocin in drip. Under all aseptic precautions, a breech 1.1kg male baby was delivered three hours later. Post-delivery status of the patient was uneventful except for two episodes of fever for two days serially on day five and day six. Both mother and the baby were discharged after 43 days of in-ward stay, both symptomatically alright. The mother was advised to continue antiretroviral therapy and get six monthly CD-4 (cluster of differentiation 4) counts for review and the baby was to be kept on top feeds till six months of age at the request of the patient. Keeping the following guidelines in mind, a multidisciplinary approach works best for such cases of HIV-infected mothers. However, it is necessary to individualise each patient.