A woman is 32 weeks pregnant. She is HIV-positive but asymptomatic. What would be important in managing her pregnancy and delivery?
1. An amniocentesis at 30 and 36 weeks
2. Weekly nonstress testing beginning at 32 weeks' gestation
3. Application of a fetal scalp electrode as soon as her membranes rupture in labor
4. Administration of intravenous antibiotics during labor and delivery
2
Rationale 1: All invasive procedures that would expose the uninfected infant to the HIV virus are avoided.
Rationale 2: Patients who are HIV-positive are considered high-risk pregnancies. Therefore, beginning at about 32 weeks, these patients have weekly nonstress tests to assess for placental function, and an ultrasound every 2–3 weeks to assess for intrauterine growth retardation (IUGR).
Rationale 3: All invasive procedures that would expose the uninfected infant to the HIV virus are avoided.
Rationale 4: Antibiotics would be ineffective for either the mother or the infant who was HIV-positive.
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