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Case 3: Perinatal HIV Transmission and Route of Delivery

You answered:

C Continue to counsel her about the efficacy of HAART in reducing mother-to-child HIV transmission, arrange for an elective cesarean section delivery at 38 completed weeks of gestation, and give intravenous zidovudine starting 3 hours prior to the cesarean section.

This answer is correct. For HIV-infected women who have a viral load greater than 1,000 copies/ml at (or near) delivery, cesarean section significantly reduces the risk of maternal-to-child HIV transmission. It is important to schedule cesarean delivery at 38 weeks completed gestation, since the benefit of cesarean section is markedly reduced if the woman presents more than 4 hours after rupture of membranes.


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