Are there additional interventions to reduce the risk of MTCT and improve maternal/fetal health?
When the woman is HIV positive there are interventions that can reduce the risk of MTCT. • Pregnant women with HIV should be counseled to refrain from cigarette smoking, injection and illicit drug use, and unprotected sexual intercourse with multiple sex partners. • STDs in pregnancy should be treated since they are associated with a higher risk of vertical transmission. Can cesarean section reduce the risk of MTCT? Elective cesarean section reduces the risk of perinatal transmission and should be offered at 38 weeks to pregnant women when the viral load is likely to be >1,000 c/mL at delivery (Dominguez, 2003). ACOG in a joint statement with the American Academy of Pediatrics (AAP) recommended offering HIV-positive pregnant women scheduled cesarean section at 38 weeks gestation (AAP, ACOG, 1999; CDC, 2001), rather than waiting until 39 weeks. There is no evidence of benefit of C-section after onset of labor, after rupture of membranes, or in women with viral loads of <1000 c/mL. What
