All can be used to lower mother-to-child HIV spread except:
Ans. is b, i.e. Omitting ergometrineRef. Harrison 17/e, p 1145; Dutta Obs. 7/e, p 302, 303; Williams 22/e, p 1316, 23/e, p 1252, 1253For prevention of mother-to-child transmission, the following steps are advocated intrapartum.1. Nevirapine/zidovudine during labor2. If viral copies are >1000/ml, then elective cesarean should be done, otherwise vaginal delivery can be attempted.3. Women with HIV infection should be scheduled for induction of labour or cesarean delivery at 38 weeks of gestation. The reason for this timing of delivery is to avoid rupture of membranes before labour.4. Avoid breastfeeding.5. If vaginal delivery is being done, ARM during labour is avoided.6. The newborn of HIV-infected mother is treated with oral zidovudine, 2 mg/kg every 6 hrs for the first 6 weeks of life.7. There is no role of vitamin A supplementation in preventing transmission, but it is seen that vitamin A deficiency has been noted in pregnant females with HIV. So, vitamin A supplementation is done.
Elective CS
Omitting ergometrine
ART
Intrapartum nevirapine
Medical & Surgical Illness Complication Pregnancy