A 37 weeks pregnant woman attends an antenatal clinic at a Primary Health Centre. She has not had any antenatal visit till now. The best approach regarding tetanus immunization in this case would be to-

Ans. is 'a' i.e., Give a dose of Tetanus Toxoid (TT) and explain to her that it will not protect the new born and she should take the second dose after four weeks even if she delivers in the meantime Guidelines on TT in pregnancy: Primigravida: 2 doses 1 month apa, after I trimester Duration of Protection with 2 doses : All subsequent pregnancies in next 5 years. Multigravida (completely immunized in last 5 years): 1 booster dose is sufficient Multigravida (paially immunized in previous pregnancy in last 5 years): 2 doses, 1 month apa, after I trimester. Multigravida (unimmunized in previous pregnancy in last 5 years): 2 doses, I month apa, after I trimester Multigravida (completely immunized in previous pregnancy earlier than 5 years): 2 doses, I month apa, after I trimester. Rule for Delayed immunization of TT in pregnancy (as per Period of gestation -- POG): Give 2 doses of TT, 1 month apa, anytime after 1st trimester, of pregnancy, Irrespective of time of delivery (so as to provide protection for atleast next 5 years).