Booking Checklist

Document review date February 2025.

NSD610-019.02 SPAIIN – Perinatal HIV Care Pathway – Booking Checklist

Please complete the Booking Checklist electronically or print off and complete a paper version.

Obstetric Management

Woman’s Health

  • Ensure folic acid started.
  • Infant feeding discussed.
  • Delivery plan discussed.
  • The combined screening test for trisomy 21 is recommended as this has the best sensitivity and specificity and will minimise the number of women who may need invasive testing.
  • Invasive prenatal diagnostic testing should not be performed until after the HIV status of the mother is known and should ideally be deferred until HIV PCR has been adequately suppressed.
  • If not on treatment and the invasive diagnostic test procedure cannot be delayed until viral suppression is achieved, it is recommended that women should commence antiretroviral therapy (ART) to include raltegravir or dolutegravir and be given a single dose of nevirapine 200mg 2-4 hours prior to the procedure.
  • See BHIVA 2018 (2020 third interim update) Pregnancy Guidelines – Section 8: Obstetric Management
  • Sexual Health Screening
  • Check sexual health screening carried out and negative. (If positive, genital tract infections should be treated according to BASHH guidelines)
  • HIV Management and Prevention of Transmission

HIV Specific Care – New Diagnosis

  • Positive result given with specialist BBV team member who liaises with obstetrician to support giving diagnosis.
  • Inform paediatric neonatologist of result.
  • Patient referred to specialist teams as part of ANC.
  • Patient referred to specialist centre for HIV care and initial consultation as soon as possible.
  • Confirmatory and baseline bloods taken including HBV, HCV and resistance test.
  • Ensure patient registered with GP.
  • Measures taken for PMTCT discussed with patient and need to start on ART either for own health or for PMTCT depending on initial baseline blood tests.
  • Efficacy of success rates discussed.
  • Discuss aim to start ART as soon as possible.
  • In women who commence ART in pregnancy an HIV PCR should be performed 2-4 weeks after commencing ART, at least once every trimester and at delivery, as per BHIVA guidelines.
  • LFTs should be performed as per routine initiation of ART and then with each routine blood test.