The mode of delivery for an HIV-positive pregnant woman is typically planned based on what factor?

• A. Maternal blood type
• B. Viral load near delivery
• C. Fetal sex
• D. Maternal age

Answer: (B)

The key idea is that the plan for how a fetus will be delivered in an HIV-positive pregnancy hinges on how well the virus is controlled in the mother near term. The goal is to minimize the risk of transmitting HIV during birth, which is closely tied to the maternal viral load at delivery. If the HIV RNA is suppressed and undetectable near labor, vaginal delivery is typically allowed with continued antiretroviral therapy and appropriate intrapartum prophylaxis. If the viral load remains high or is unknown near delivery, an elective cesarean before labor begins is usually recommended to reduce transmission risk. Maternal blood type, fetal sex, or maternal age do not influence this transmission risk or the delivery decision in this scenario.