A 27-year-old woman, gravida 1 para 0, presents to her obstetrician at 12 weeks of gestation for routine prenatal care. She has no significant medical history and reports feeling well, with no symptoms of fatigue, jaundice, or abdominal pain. Her family history is notable for hepatitis B in her mother. As part of routine prenatal testing, the patient’s hepatitis B surface antigen (HBsAg) is found to be positive. Further tests reveal the following: HBeAg: Positive HBV DNA Levels: 1,000,000 IU/mL Liver Function Tests: Normal (ALT and AST within normal limits). Which medication is considered safe and effective for reducing maternal viral load in hepatitis B-positive pregnant women?

A 28-year-old woman, gravida 1 para 0, presents to her obstetrician at 12 weeks of gestation for routine prenatal care. She has no significant medical history and reports feeling well, with no symptoms of fatigue, jaundice, or abdominal pain. Her family history is notable for hepatitis B in her mother. As part of routine prenatal testing, the patient’s hepatitis B surface antigen (HBsAg) is found to be positive. Further tests reveal the following: HBeAg: Positive HBV DNA Levels: 1,000,000 IU/mL Liver Function Tests: Normal (ALT and AST within normal limits). What is the most effective strategy to prevent perinatal transmission of hepatitis B from a mother with a high viral load?

A 32-year-old pregnant woman at 36 weeks of gestation attends her routine prenatal visit. She was diagnosed with HIV during her first trimester and initiated on antiretroviral therapy (ART) with a combination of tenofovir, emtricitabine, and dolutegravir. Her prenatal course has been uneventful. There is no evidence of opportunistic infections or pregnancy-related complications. Clinical Assessment: Current viral load: 1,200 copies/mL. CD4 count: 500 cells/μL. At what gestational age is an elective cesarean delivery typically scheduled for an HIV-positive mother with a viral load >1,000 copies/mL?

A 32-year-old pregnant woman at 36 weeks of gestation attends her routine prenatal visit. She was diagnosed with HIV during her first trimester and initiated on antiretroviral therapy (ART) with a combination of tenofovir, emtricitabine, and dolutegravir. Her prenatal course has been uneventful. There is no evidence of opportunistic infections or pregnancy-related complications. In which scenario is a cesarean delivery most strongly recommended for an HIV-positive mother to reduce the risk of mother-to-child transmission?

A 29-year-old woman, G2P1, presents to the labor and delivery unit at 39 weeks of gestation in active labor. She reports spontaneous rupture of membranes approximately 12 hours ago and has had mild intermittent contractions over the past 6 hours. Key History: Positive GBS screening at 36 weeks gestation. Stable maternal vitals, reassuring fetal heart rate. Cervical exam: 4 cm dilation, 80% effacement, -1 station. The obstetric team decides to initiate intrapartum GBS antibiotic prophylaxis due to her positive GBS status and prolonged rupture of membranes. What is the first-line antibiotic for intrapartum GBS prophylaxis?