【文章內(nèi)容簡介】 women ? 為孕產(chǎn)婦提供規(guī)范的艾滋病抗體篩查，及時(shí)對艾滋病篩查結(jié)果陽性者進(jìn)行艾滋病確認(rèn)試驗(yàn) ； ? To provide standardized HIV antibody screening tests to pregnant women and timely provide confirmatory tests to those who are positive at screening tests ? 要確保臨產(chǎn)孕產(chǎn)婦盡早獲得艾滋病抗體篩查，以及時(shí)為孕產(chǎn)婦及所生兒童提供艾滋病母嬰傳播的干預(yù)措施 ? To ensure all pregnant women showing up in labor access to HIV antibody screening tests ASAP, and provide timely PMTCT services to mothers and infants ? 為孕產(chǎn)婦提供規(guī)范的梅毒篩查和復(fù)檢，確定是否梅毒感染 ? To provide standardized syphilis screening and confirmatory tests to all pregnant women in order to determine syphilis infection diagnosis ? 為孕產(chǎn)婦進(jìn)行乙肝病毒表面抗原檢測 ， 有條件的機(jī)構(gòu)為檢測結(jié)果陽性者提供乙肝病毒病原體血清學(xué)（乙肝兩對半）檢測。 ? To Provide HBV surface antigen tests to all pregnant women. If possible, provide HBV all markers to HBsAg positives. 措施 Measure3 加強(qiáng)感染孕產(chǎn)婦及所生兒童孕產(chǎn)期和兒童保健服務(wù) Strengthen ANC and infant care services to infected women and their babies ? 各級醫(yī)療保健機(jī)構(gòu)均應(yīng)提供 All levels medical centers should provide: ? 艾滋病、梅毒或乙肝感染孕產(chǎn)婦：加強(qiáng)常規(guī)孕產(chǎn)期保健，提供隨訪、安全助產(chǎn)、心理支持、家庭防護(hù)等服務(wù) ? For HIV, syphilis or HBV infected pregnant women: strengthen routine prenatal care, followup, safe delivery, psychological support and family protection services ? 所生兒童：有針對性的護(hù)理，喂養(yǎng)指導(dǎo)，加強(qiáng)常規(guī)兒童保健及生長發(fā)育監(jiān)測，預(yù)防營養(yǎng)不良等 ? Infants: specific care, feeding instruction, growth monitoring and malnutrition prevention etc. ? 為自愿選擇終止妊娠的感染孕產(chǎn)婦提供安全的終止妊娠服務(wù) ? Provide safe end term services for women who voluntarily want to terminate pregnancy 措施 Measure4 艾滋病感染孕產(chǎn)婦及所生兒童 的 干預(yù)措施 Interventions to HIV infected mothers and their babies 措施內(nèi)容： Contents: ? 應(yīng)用抗艾滋病病毒藥物。 Use ARVs ? 提供適宜的安全助產(chǎn)服務(wù)。 Provide appropriate safe delivery services ? 提供科學(xué)的嬰兒喂養(yǎng)咨詢、指導(dǎo)。 ? Provide scientific counseling and guidance for infant feeding ? 為所生兒童提供隨訪與艾滋病檢測。 ? Provide HIV testing and followup services to infants born to HIV positive mothers ? 預(yù)防性應(yīng)用復(fù)方新諾明。 SMZ prophylaxis treatment 艾滋病感染孕產(chǎn)婦及所生兒童 HIV infected mothers and their children ——抗病毒藥物方案 ARV regimen ? 預(yù)防性應(yīng)用抗病毒藥物 HAART for prevention ? 處于艾滋病臨床 I期或 II期，免疫功能相對較好， CD4+T淋巴細(xì)胞計(jì)數(shù) 350/mm3的艾滋病感染孕產(chǎn)婦 ? AIDS Clinical stage I or II, good immune status, CD4 350/mm3 孕 14周 ~ 14 weeks of gestation~ 臨產(chǎn)及分娩 Labor and Delivery 產(chǎn)后 Post delivery 孕產(chǎn)婦 Pregnant Women 所生兒童 Infants AZT+3TC+LPV/r或 or EFV AZT+3TC +LPV/r或 or EFV 人工喂養(yǎng)：停止用藥 Formula feeding: Stop ART 母乳喂養(yǎng)：用藥持續(xù)至停止母乳喂養(yǎng)后 1周 Breastfeeding: ART until 1 week post to wean for breastfeeding AZT or NVP for 46 weeks ASAP (within 612 hours) after delivery regardless of feeding mode 無論采取何種喂養(yǎng)方式出生后盡早（ 6~12小時(shí)內(nèi)）開始用藥 AZT或 NVP， 4~6周 ? 治療 性應(yīng)用抗病毒藥物 HAART for mothers’ own health ? 處于艾滋病臨床 Ⅲ 期或 Ⅳ 期， CD4+T淋巴細(xì)胞計(jì)數(shù) ≤350/mm3的艾滋病感染孕產(chǎn)婦 ? AIDS Clinical Stage Ⅲ or Ⅳ ,CD4 ≤350/mm3 孕期盡早 As early as possible during pregnancy 臨產(chǎn)及分娩 Labor and Delivery 產(chǎn)后 post delivery AZT+3TC+NVP或 or EFV AZT+3TC +NVP或 or EFV 持續(xù)、終生服藥Continue to lifelong treatment AZT+3TC+NVP或 EFV 孕產(chǎn)婦 Pregnant Women 所生兒童 Infants AZT or NVP for 46 weeks ASAP (within 612 hours) after delivery regardless of feeding mode 無論采取何種喂養(yǎng)方式出生后盡早（ 6~12小時(shí)內(nèi)）開始用藥 AZT或 NVP， 4~6周 ? 孕期沒有接受 HIV檢測，臨產(chǎn)時(shí)才 發(fā)現(xiàn)感染 的孕產(chǎn)婦 HIV detected in late pregnancy (at delivery) 孕 14周 ~ 14 weeks gestation 臨產(chǎn)及分娩Labor and delivery 產(chǎn)后 post delivery 人工喂養(yǎng) Formula feeding 母乳喂養(yǎng) Breastfeeding 產(chǎn)婦： Mothers AZT+3TC+單劑量 NVP monotherapy 產(chǎn)婦 Mothers： AZT+3TC， 7天 days 兒童 ：出生后盡早（ 6~12小時(shí)內(nèi)） children : ASAP after delivery (within 612 hours) 單劑量 monotherapy NVP + 4~6周 weeks AZT, or 或 NVP，每天 1次 QD， 4~6周 weeks 產(chǎn)婦 Mothers： Continue treatment until 1 week of wean for breastfeeding 持續(xù)用藥至停止母乳喂養(yǎng)后 1周 兒童 ：出生后盡早（ 6~12小時(shí)內(nèi)） Children： ASAP after delivery (within 612 hours) NVP，每天 1次 qd， 6周 6 weeks 產(chǎn)婦 Mothers：AZT+3TC +LPV/r或 or EFV 產(chǎn)婦 Mothers： AZT+3TC， 7天 days 兒童：出生后盡早（ 6~12小時(shí)內(nèi)） Children： ASAP after delivery (within 612 hours) NVP，每天 1次 qd，持續(xù)至停止母乳喂養(yǎng)后 1周Continue treatment until 1 week of wean for breastfeeding 產(chǎn)婦 Mothers：AZT+3TC+單劑量 montherapy NVP 方案一Regimen 1 方案二 Regimen 2 ?盡早住院分娩 ?Earlier admission to hospital for delivery ?安全助產(chǎn)，避免不必要的侵入性操作 ?Safe delivery, avoiding unnecessary invasive procedures 提供適宜的安全助產(chǎn)服務(wù) Provide appropriate safety delivery service ?提倡人工喂養(yǎng) ， 避免母乳喂養(yǎng) ， 杜絕混合喂養(yǎng) ?Encourage formula feeding, avoide breastfeeding, do not mix ?人工喂養(yǎng)條件評估 ， 符合條件給予人工喂養(yǎng)指導(dǎo)與支持 ?Evaluate conditions for formula feeding, if appropriate, encourage mothers to give formula feeding ?暫不具備人工喂養(yǎng)條件 ， 純母乳喂養(yǎng)最好不超過 6個(gè)月 ?If formula feeding cannot be implemented, exclusive breastfeeding cannot exceed 6 months 提供科學(xué)的嬰兒喂養(yǎng)咨詢、指導(dǎo) Provide scientific counseling and guidance for breastfeeding 艾滋病感染孕產(chǎn)婦所生兒童 Infants born to HIV + mothers ——隨訪及檢測 followup and testing ?兒童 滿 12和 18月齡 進(jìn)行隨訪 ?Followup at1,3,6,9,12 and 18 months for infants ?出生后 6周及 3個(gè)月（或其后盡早）采血進(jìn)行早期診斷檢測 ?Blood test for EID at 6 weeks and 3 months (on an ASAP basis) after birth ?未進(jìn)行艾滋病感染早期診斷檢測或早期診斷檢測結(jié)果陰性者， 12月齡、18月齡抗體檢測 ?Children who failed to have EID or with negative EID result, should go for an antibody test when reaching 12 months and 18 months 措施 Measure 5 梅毒感染孕產(chǎn)婦及所生兒童 的 干預(yù)措施 Intervention to syphilis infected mothers and their infants 措施內(nèi)容： Contents ? 為梅毒感染孕婦提供規(guī)范治療。 Provide the standardized treatment for syphilis infected mothers ? 提供安全助產(chǎn)服務(wù)。 Provide