An HIV-infected pregnant woman under your care presents for her 36-week prenatal visit. Which of the following discussion points is true:
All HIV-infected women should have a cesarean delivery.
She may have a vaginal delivery only if her viral load is < 100 copies/mL
If her viral load is >1,000 copies/mL, you will schedule cesarean delivery for 38 weeks
She can deliver vaginally regardless of viral load because she is on highly active antiretroviral therapy
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
Obstetrics