Reason for C-section

[MudPhud20XX]

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So if a mother is HIV positive and the virus load is high, C-section is preferred to prevent vertical transmission to the baby. But why is C-section safer compared to the vaginal delivery? The baby is just passing through the birth canal, so I feel like this might be a safer way to get the baby out without exposing the baby to Mom's blood right?

Also, these viruses associated with congenital diseases (HIV, CMV), don't they also cross the placenta?

Many thanks in advance.

 

[SBR249]

The NIH website had this to say about C-sections in HIV mothers with high viral load or with unknown viral load

The cesarean delivery should be performed before a woman goes into labor and before her water breaks (also called rupture of membranes).

Once a woman goes into labor or her water breaks, a cesarean delivery may no longer prevent mother-to-child transmission of HIV. In this situation, the decision whether to deliver the baby by cesarean section is based on medical reasons and not to prevent mother-to-child transmission of HIV.

And the American Pregnancy Association had this to say:

In most cases, HIV will not cross through the placenta from mother to baby. If the mother is healthy in other aspects, the placenta helps provide protection for the developing infant.

Sources:
http://aidsinfo.nih.gov/education-m...o-child-transmission-of-hiv-during-childbirth
http://americanpregnancy.org/pregnancycomplications/hivaids.html

Edit: the placental barrier topic is also talked about in this article (http://www.medscape.org/viewarticle/420653), but there is still some debate on it.

 

[igcgnerd]

Natural birth is traumatic both on baby and mom. Thus there are more likely portals of entry on baby. Elective C sections involve very little for the fetus and usually have very minimal blood loss when done under controlled conditions (ie not a crash/ emergent c section).

 

[Transposony]

So if a mother is HIV positive and the virus load is high, C-section is preferred to prevent vertical transmission to the baby. But why is C-section safer compared to the vaginal delivery? The baby is just passing through the birth canal, so I feel like this might be a safer way to get the baby out without exposing the baby to Mom's blood right?

Also, these viruses associated with congenital diseases (HIV, CMV), don't they also cross the placenta?

Many thanks in advance.

HIV is transmitted via blood as well as body secretions especially genital secretions.
So, during vaginal delivery the baby is being exposed for hours to genital secretions during labor & delivery +/_ exposure to maternal blood during delivery.
Compare this with few minutes of potential exposure to blood during C-section.

Mother-to-child HIV transmissions were 23–30% before birth, 50–65% during birth, and 12–20% via breast-feeding.