What maternal treatment should be given during labor and delivery?

The Illinois Perinatal HIV Hotline recommends intravenous AZT to be given during labor and delivery (See Hotline Best Practices for HIV-positive Women in Labor). Ideally, this should be started at the onset of uterine contractions with a goal of completing at least a 3 hour course prior to delivery in order to achieve adequate maternal and neonatal serum levels. AZT is given as an intravenous 2mg/kg load infusion given over the first hour followed by 1mg/kg/hour intravenously until delivery. Other antiretroviral medications should be continued during labor to ensure that their normal antiretroviral regimen is uninterrupted.