Pediatrician (St. Petersburg)Pediatrician (St. Petersburg)2079-78502587-6252Eco-Vector1916510.17816/PED105101-104Research ArticleThe results of efferent therapy by woman with HIV infection, with amniotic fluid outflow at 23 weeks with growth retardation syndrome of 2 fetusVetrovVladimir V.<p>MD, PhD, Dr Med Sci, Head of Cabinet of Extracorporeal Therapies of Perinatal Center</p>vetrovplasma@mail.ruIvanovDmitry O.<p>MD, PhD, Dr Med Sci, Professor, Rector</p>Radiology@mail.ruReznikVitaly A.<p>MD, PhD, Associate Professor, Head Physician on Obstetrics and Gynecology</p>vitaliy-reznik@mail.ruRomanovaLarisa A.<p>Head, Department of Pregnancy Pathology of the Perinatal Center</p>l_romanova2011@mail.ruMelashenkoTat’yana V.<p>MD, PhD, Neurologist, Anesthesiology and Intensive Care Neonatal Perinatal Center, Ultrasonic Diagnostic Doctor of Radiation Diagnostics Department No. 2</p>melashenkotat@mail.ruShandrenkoKsenia A.<p>Clinical Intern, Department of Obstetrics & Gynecology</p>kshand@mail.ruKrivolesovaTatiana A.<p>Head, Сlinical-Diagnostic Department of Perinatal Center</p>krivolesova.ta@mail.ruSt. Petersburg State Pediatric Medical University, Ministry of Healthcare of the Russian Federation281220191051011042801202028012020Copyright © 2020, Vetrov V.V., Ivanov D.O., Reznik V.A., Romanova L.A., Melashenko T.V., Shandrenko K.A., Krivolesova T.A.2020<p>In the article presents data on the management of a 48-year-old patient with HIV infection, urogenital infection with pregnancy, which occurred as a result of IVF, with premature effusion of amniotic fluid at 23 weeks of pregnancy with the syndrome of growth retardation of 2 fetus in monochoric diamniotic twins. After the discharge of the amniotic fluid, the patient was treated for six days in an infectious hospital, then transferred to the perinatal center, where blood tests noted moderatemanifestations of endotoxicosis, increased levels of aminotransferases and an inflammatory reaction of the body. The course of treatment included detoxification methods (plasmapheresis, hemosorption, photomodification of blood with ultraviolet, laser rays), which contributed to the normalization of blood tests, prolongation of pregnancy for another three weeks in the absence of septic complications after operative childbirth in the mother and in newborn girls. At birth, 1 childs weight, body length and Apgar score were 750 g., 29 sm. and<sup>3</sup>/<sub>5</sub>points, respectively, in 2 children 590 g., 30 sm. and<sup>1</sup>/<sub>3</sub>points, respectively. The children required treatment from resuscitators, at the second stage of nursing, from rehabilitation specialists.</p>HIV infectiontwins monochorionic diamniotic twinsgrowth retardation of the fetuspremature effusion of amniotic fluidinflammationpremature birthplasmapheresisphotomodification bloodВИЧ-инфекциямонохориальная диамниотическая двойнязадержка роста плодапреждевременное излитие водвоспалениепреждевременные родыплазмаферезфотомодификация крови[Ветров В.В., Иванов Д.О. Плод как пациент трансфузиолога. – СПб: ИнформНавигатор, 2016. – 112 с. [Vetrov VV, Ivanov DO. Plod kak patsient transfuziologa. Saint Petersburg: InformNavigator; 2016. 112 p. (In Russ.)]][Стрижаков А.Н., Тимохина Е.В., Игнатко И.В., Белоцерковцева А.Д. Патофизиология плода и плаценты. – М., 2015. – 176 с. [Strizhakov AN, Timokhina EV, Ignatko IV, Belotserkovtseva AD. Patofiziologiya ploda i platsenty. Moscow; 2015. 176 p. (In Russ.)]][Терехина Л.А. Беременность и перинатальные исходы у ВИЧ-инфицированных женщин: Автореф. дис. … канд. мед. наук. – М., 2008. [Terekhina LA. Beremennost’ i perinatal’nye iskhody u VICh-infitsirovannykh zhenshchin. [dissertation] Moscow; 2008. (In Russ.)]][Liem SM, van Baaren GJ, Delemarre FM, et al. Economic analysis of use of pessary to prevent preterm birth in women with multiple pregnancy (ProTWIN trial). Ultrasound Obstet Gynecol. 2014;44(3):338-345. https://doi.org/10.1002/uog.13432.]