Reduce obstetric risk of HIV transmission

Clinical description

• Use a partograph to allow early detection and management of prolonged labour.
• Artificial rupture of membranes (ARM) increases the risk of HIV transmission.

o ARM is not indicated if labour is progressing well.

o If prolonged labour due to poor uterine contraction: perform ARM at ≥6cm cervical dilation and augment with oxytocin (Pitocin).

• Do not perform routine episiotomy except for specific obstetric indications (e.g., vacuum

extraction).

• Avoid frequent vaginal examinations.
• Do not ‘milk’ the umbilical cord before cutting.
• Do not suction a new-born with a naso-gastric tube unless there is meconium-stained liquor.
• Immediately after birth, wipe the new-born dry with a towel to remove maternal body fluids.

106 Newborn care and postnatal follow up