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Test 3: HIV during labour and delivery

  1. What is the chance of mother-to-infant transmission of HIV during labour and vaginal delivery if the woman is not receiving antiretroviral prophylaxis?
    • 5%
    • 15%
    • 25%
    • 50%
  2. Can HIV infection be diagnosed for the first time during labour?
    • Yes, by using a rapid screening test
    • Only if the labour lasts longer than 12 hours as the test takes many hours to perform
    • Only if the woman has clinical signs of AIDS
    • No
  3. During labour, women who are HIV positive should be:
    • Isolated in a single ward and barrier nursed
    • Cared for with other women in the general labour ward
    • Cared for in a clinic only and not admitted to a hospital if complications develop
    • Always be cared for at home where they cannot infect other patients
  4. In women who are HIV positive, the membranes should:
    • Be ruptured as soon as possible to speed up the labour
    • Be ruptured when the cervix reaches 4 cm dilatation
    • Only be ruptured when the cervix is 8 cm dilated
    • Not be artificially ruptured unless there is a good clinical indication
  5. In women with HIV infection:
    • The risk of preterm labour is the same as in HIV-negative women
    • The risk of preterm labour is doubled
    • The risk of preterm labour is reduced
    • Preterm labour is rare
  6. The risk of vertical transmission is increased in:
    • Preterm labour
    • Post-term labour
    • Term labour
    • Rapid labours
  7. Does HIV infection in a well-nourished mother cause intra-uterine growth restriction?
    • Usually it does
    • Usually it does not
    • Only if the mother is receiving zidovudine (AZT)
    • Only if chorioamnionitis is present
  8. The following procedure may reduce the risk of mother-to-infant transmission of HIV, especially if ARV prophylaxis has not been used:
    • Elective Caesarean section
    • A Caesarean section while in labour
    • An episiotomy
    • Vacuum extraction
  9. Caesarean section in HIV-positive women:
    • Increases the risk of maternal wound sepsis
    • Decreases the risk of maternal pneumonia in the puerperium
    • Increases the risk of bacterial infection in the infant
    • Decreases the risk of hyaline membrane disease in the infant
  10. In HIV-positive women, an episiotomy should:
    • Be done routinely to shorten the second stage of labour
    • Should never be done because it does not heal
    • Should only be done if there is a good clinical reason as it may increase the risk of vertical transmission to the infant
    • Only be done by a doctor
  11. Which HIV-positive women are at greatest risk of transmitting the virus to their infant?
    • Women in the latent phase of the infection
    • Women who have clinical signs of advanced HIV disease
    • Women who have short labours
    • Women who have not transmitted HIV to their previous children
  12. The following procedure may reduce the risk of mother-to-infant transmission of HIV during labour and delivery by 50% if an unbooked mother is diagnosed to be HIV positive when admitted in labour:
    • Giving the infant intramuscular vitamin K after delivery
    • Active management of the third stage of labour
    • Speed up labour with an oxytocin infusion
    • Giving the mother a single dose of NVP
  13. Vaginal wiping with chlorhexidine during labour in HIV-positive women may:
    • Reduce the risk of HIV transmission
    • May reduce the risk of puerperal sepsis and neonatal sepsis
    • Cause inflammation and increase the risk of HIV transmission
    • Reduce the risk of meconium aspiration
  14. After delivering the infant of an HIV-positive woman:
    • The infant’s mouth should be well suctioned.
    • The infant should not be fed for 12 hours.
    • The infant should be well dried.
    • The infant should not be given to the mother for at least six hours.
  15. During labour and delivery mothers on FDC should:
    • Receive a single dose of NVP
    • Continue with daily FDC
    • All ARV drugs should temporarily be stopped and only restarted after delivery
    • Receive 3 hourly AZT
  16. What drugs should be given to women at the same time or after delivery if they receive a single dose of nevirapine in labour?
    • AZT and 3TC
    • TDF and FTC (Truvada)
    • Nevirapine and AZT
    • Lopinavir and ritonavir
  17. Which risk factor is associated with an increased risk of HIV transmission during labour even if ARV drugs are used correctly for prophylaxis or treatment?
    • Elective Caesarean section
    • Postterm delivery
    • Male infant
    • A high viral load
  18. How can staff reduce the risk of becoming infected with HIV themselves during the management of labour?
    • They should not perform vaginal examinations.
    • They should not rupture the membranes.
    • They should wear gloves.
    • They should be immunised against HIV.
  19. How can staff reduce the risk of becoming infected themselves with HIV during Caesarean section or episiotomy repair?
    • Needles should always be held with forceps.
    • The patient must be washed with chlorhexidine.
    • Hands should be washed after the procedure is completed.
    • Needles must be hand held whenever possible.
  20. What form of family planning will reduce the risk of spreading HIV to a sexual partner?
    • Tubal ligation
    • Injectables, such as Depo-Provera
    • Male or female condoms
    • Oral contraceptives