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Gynaecology & Obstetrics Obstetrics 6379eb1a

An HIV-infected pregnant woman under your care presents for her 36-week prenatal visit. Which of the following discussion points is true:

A
All HIV-infected women should have a cesarean delivery.
B
She may have a vaginal delivery only if her viral load is < 100 copies/mL
C
If her viral load is >1,000 copies/mL, you will schedule cesarean delivery for 38 weeks
D
She can deliver vaginally regardless of viral load because she is on highly active antiretroviral therapy
High-Yield Explanation
Most recommendations of NACO and WHO now say that there is no significant advantage of doing a cesarean section instead of a normal vaginal delivery since a Cesarean does not reduce the perinatal transmission in anyway different from a normal vaginal delivery However, practical impoance is given to high viral loads i.e. HIV RNA >1000 copies/ml - C-section at 38 weeks HIV RNA <1000 copies/ml - Vaginal delivery can be done

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