{"id":479,"date":"2017-04-03T10:29:40","date_gmt":"2017-04-03T09:29:40","guid":{"rendered":"http:\/\/www.mcns.scot.nhs.uk\/spaiin\/?page_id=479"},"modified":"2025-02-25T13:24:15","modified_gmt":"2025-02-25T13:24:15","slug":"healthy-pregnancy-late-presenter","status":"publish","type":"page","link":"https:\/\/www.nn.nhs.scot\/spaiin\/professionals\/guidance\/perinatal-hiv-care-pathway\/healthy-pregnancy-late-presenter\/","title":{"rendered":"Late Presenter Checklist"},"content":{"rendered":"\n<p><a href=\"https:\/\/www.spaiin.scot.nhs.uk\/wp-content\/uploads\/sites\/30\/2024\/02\/NSD610-019.06-SPAIIN-Perinatal-HIV-Care-Pathway-\u2013-Late-Presenter-V3.docx\" data-type=\"attachment\" data-id=\"1443\">NSD610-019.06 SPAIIN &#8211; Perinatal HIV Care Pathway \u2013 Late Presenter<\/a><\/p>\n\n\n\n<p>Please download and complete the late presenter checklist electronically or print off and complete a paper version.<\/p>\n\n\n\n<p><strong>As a matter of urgency please contact a specialist centre (in NHS Lothian or NHS GG&amp;C) for advice.<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>See BHIVA 2018 (2020 third interim update) <a href=\"https:\/\/www.bhiva.org\/file\/5f1aab1ab9aba\/BHIVA-Pregnancy-guidelines-2020-3rd-interim-update.pdf\">Pregnancy Guidelines \u2013 Section: 6.4 Late-presenting women not on treatment<\/a>.<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>A woman who presents after 28 weeks should commence ART without delay if not already on.<\/li>\n\n\n\n<li>If the HIV PCR is unknown or &gt;100 000 HIV RNA copies\/mL a three \u2013 or four \u2013 drug regimen that includes raltegravir 400mg BD or dolutegravir 50mg OD is suggested.<\/li>\n\n\n\n<li>An untreated woman presenting in labour at term should be given a stat dose of nevirapine 200mg and commence oral zidovudine 300mg with lamivudine 150mg BD and raltegravir 400mg BD.<\/li>\n\n\n\n<li>Intravenous zidovudine should be infused for the duration of the labour and delivery.<\/li>\n\n\n\n<li>In preterm labour (&lt; 37+0 weeks), if the baby&nbsp;is unlikely to be able to absorb oral medications, consider the addition of a stat dose of tenofovir 490mg to the treatment in recommendations above to further load the baby.<\/li>\n\n\n\n<li>Women presenting in labour\/with rupture of membranes (ROM)\/requiring delivery without a documented HIV result must be recommended to have an urgent HIV test.<\/li>\n\n\n\n<li>A reactive\/positive result must be acted upon immediately with initiation of the interventions for prevention of vertical transmission of HIV without waiting for further\/formal serological confirmation.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p class=\"nhsuk-card__description\">NSD610-019.06 SPAIIN &#8211; Perinatal HIV Care Pathway \u2013 Late Presenter Please download and complete the late presenter checklist electronically or [&hellip;]<\/p>\n","protected":false},"author":5,"featured_media":0,"parent":452,"menu_order":5,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-479","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.nn.nhs.scot\/spaiin\/wp-json\/wp\/v2\/pages\/479","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.nn.nhs.scot\/spaiin\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.nn.nhs.scot\/spaiin\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.nn.nhs.scot\/spaiin\/wp-json\/wp\/v2\/users\/5"}],"replies":[{"embeddable":true,"href":"https:\/\/www.nn.nhs.scot\/spaiin\/wp-json\/wp\/v2\/comments?post=479"}],"version-history":[{"count":13,"href":"https:\/\/www.nn.nhs.scot\/spaiin\/wp-json\/wp\/v2\/pages\/479\/revisions"}],"predecessor-version":[{"id":1597,"href":"https:\/\/www.nn.nhs.scot\/spaiin\/wp-json\/wp\/v2\/pages\/479\/revisions\/1597"}],"up":[{"embeddable":true,"href":"https:\/\/www.nn.nhs.scot\/spaiin\/wp-json\/wp\/v2\/pages\/452"}],"wp:attachment":[{"href":"https:\/\/www.nn.nhs.scot\/spaiin\/wp-json\/wp\/v2\/media?parent=479"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}