Examinations

In Germany, all pregnant women are advised to undergo regular medical examinations in order to avoid complications. For you as a woman with HIV, this is especially important – even if you feel healthy and are not having any discomfort.

Laboratory tests

You should get your blood tested on a regular basis. Your laboratory values offer important information about your health. The following should be checked on a regular basis:

  • Haematosis, to check for anaemia. Anaemia may occur during pregnancy.
  • Viral load (amount of virus in the blood). The viral load provides information on how active the virus is and how well the HIV medication is working. If there are less than 50 viral copies per millilitre of blood, the HIV therapy is working well, and your child is protected from infection.
  • Immune cells (number of CD4 cells in the blood). This test provides information about the state of your immune system. The HIV infection destroys immune cells, but the HIV medication helps the system recover: the number of immune cells increases and remains at a high level.
  • Liver and kidney values to check on how your body is tolerating the medication.

Resistance test

This test is carried out before starting HIV treatment to determine whether the virus is already resistant against certain medication. This could be the case if you got infected by a person undergoing HIV therapy who has become resistant to the medication. A resistance test is also carried out if laboratory tests show that the HIV therapy is not working. In that case the medication that is no longer effective is replaced by another HIV medication.

For the resistance test, blood will be drawn from you to be tested in the laboratory.

Glucose screening test

Pregnancy as well as HIV treatment can cause diabetes which may be harmful to the unborn child. Therefore, your doctor will offer you a glucose test between the 24th and 28th week of pregnancy: this is a blood draw after consuming sugary syrup. If the test reveals a disorder, you may have to be treated to protect the child.

Gynaecological examination

HIV positive pregnant women should undergo regular gynaecological examinations. During this exam, the doctor will listen to your child’s heartbeat and feel your abdomen to check the position and size of the baby. In addition, they will check the size of your womb to see how your child is developing. They will also feel whether the cervix is closed or already open, and check for a weakened cervix (which may cause a miscarriage) and infections of the vagina. Furthermore, your doctor will check your general health, e.g. by measuring your pulse and blood pressure, and by taking a urine sample.

Ultrasound (sonography)

Your doctor will recommend three ultrasound examinations during your pregnancy. The exam is carried out either via the abdomen or the vagina. It is neither dangerous for you nor for your child, and it is a painless procedure. By using ultrasound, your doctor can check how the child is developing. They can also determine whether you have any physical problems. It is important to identify complications as early as possible to ensure that you and your child get the best treatment during pregnancy and after delivery.

Colposcopy

Infections with certain types of human papillomavirus (HPV) can cause cervical cancer that is more common in women with HIV than in women who are not infected. If this is diagnosed early, the preliminary stages can be treated without any problems. Your doctor will therefore examine you with a magnifying lens (colposcope) during early pregnancy and take a cervical swab.