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“The aim of the current study was to assess the effect of maternal HIV infection, treated or untreated, on the degree of placental invasion, as assessed by the pulsatility index of the

uterine arteries during a Doppler examination at 11+0–13+6 weeks’ gestation. This was a nested case–control study in which a uterine artery Doppler examination was performed in the first trimester in 76 HIV-positive women. Each woman was matched with 30 HIV-negative women. As the pulsatility index of the uterine arteries depends on a number of maternal and fetal characteristics, its values in each case and control mTOR inhibitor were expressed as multiples of the median (MoM) of the unaffected group. Among the 76 HIV-positive women, 33 (43.4%) were on antiretroviral treatment at the time of the Doppler examination, including 14 women (42.4%) on nucleoside reverse transcriptase inhibitors (NRTIs) and a protease inhibitor, 18 women (54.5%) on NRTIs and a nonnucleoside reverse transcriptase inhibitor and one woman (3.1%) on monotherapy. Compared with the HIV-negative women, the HIV-positive women were more likely to be heavier (P<0.01), to be of African origin (P<0.01), to be nonsmokers (P=0.01) and to

deliver smaller neonates earlier (P<0.01). The median adjusted pulsatility index of the uterine arteries was not statistically different between Enzalutamide research buy the cases and controls [1.07; interquartile range (IQR) 0.85–1.24 MoM vs. 0.99; IQR 0.81–1.20 MoM; P= 0.28] or, in HIV-positive women, between those receiving and not receiving antiretroviral treatment (P=0.12). HIV-positive women with uncomplicated Org 27569 pregnancies have normal placental perfusion in the first trimester of pregnancy. The

increased incidence of HIV infection globally, the introduction of routine antenatal screening for HIV and the use of highly active antiretroviral therapy (HAART) in pregnancy have resulted in an increase in the number of pregnant women who are living with HIV. In the United Kingdom, it has been estimated that the prevalence of HIV infection in pregnancy is about 2.8 per 1000 women [1–3]. There is controversy over whether HIV infection and/or its treatment has an adverse effect on placentation and the incidence of pre-eclampsia (PE) [4–8]. The accepted model for the development of PE is based on an underperfused, hypoxic placenta which releases a pre-eclamptic factor(s), which in turn attacks the maternal endothelium, causing endothelial dysfunction and the clinical signs of PE [9]. The uteroplacental vascular adaptation to supply the fetoplacental unit is dependent on invasion of the spiral arteries by the trophoblast and their conversion from narrow high-resistance vessels to dilated low-resistance channels.