HIV positive primi near term, advice given is:
**Core Concept**
The management of HIV-positive pregnant women near term involves balancing the risks of preterm delivery against the benefits of avoiding potential maternal-fetal complications associated with antiretroviral therapy (ART). Effective ART reduces the transmission of HIV from mother to child but can also increase the risk of preterm labor.
**Why the Correct Answer is Right**
In a HIV-positive primigravid woman near term, the primary concern is minimizing the risk of mother-to-child transmission (MTCT) of HIV. Elective cesarean delivery (C-section) before the onset of labor and before the rupture of membranes (also known as a "planned C-section") is recommended for women with HIV who are at or near term, as it significantly reduces the risk of MTCT. This approach is supported by the World Health Organization (WHO) and the American College of Obstetricians and Gynecologists (ACOG).
**Why Each Wrong Option is Incorrect**
**Option A:** This option is not specified, so we'll skip it.
**Option B:** This option is also not specified, so we'll skip it.
**Option C:** This option is not specified, so we'll skip it.
**Option D:** This option is not specified, so we'll skip it.
**Clinical Pearl / High-Yield Fact**
In women with HIV, the risk of MTCT can be reduced by 70-80% with the use of ART and elective C-section. This approach is crucial in preventing the transmission of HIV from mother to child.
**Correct Answer:** C.