Question

All of the following interventions are recommended to prevent mother-to-child transmission of HIV, except:

• A. Avoid ergometrine in the third stage of labour
• B. Highly active antiretroviral therapy (HAART)
• C. Elective Caesarean section
• D. Intrapartum Zidovudine

Hint:

Three options lower viral load or birth-canal exposure; one is just a uterotonic choice.

Answer 1

The Correct Option is A

Step 1: Prevention of mother-to-child transmission (PMTCT) of HIV works by lowering the maternal viral load and reducing the baby's exposure to infected blood and secretions during birth.
Step 2: HAART given to the mother brings the plasma viral load down, ideally to undetectable, which is the single most effective measure to cut vertical transmission. So Option B is recommended.
Step 3: Elective (pre-labour) Caesarean section at term reduces transmission when the maternal viral load is high or unknown, because it avoids the baby passing through the birth canal and reduces contact with maternal blood. So Option C is recommended.
Step 4: Intrapartum intravenous Zidovudine for the mother, with neonatal prophylaxis afterwards, further lowers the risk during the high-exposure delivery window. So Option D is recommended.
Step 5: Ergometrine is a uterotonic used to prevent and treat postpartum haemorrhage. Avoiding it has no role in PMTCT; in fact, controlling blood loss matters. The caution about ergometrine relates to its interaction with protease inhibitors (risk of severe vasoconstriction), not to HIV transmission itself. So routinely "avoiding ergometrine" is NOT a PMTCT intervention.
Hence the answer is Option A (Avoid ergometrine in the third stage of labour).