Because medical therapy for a human immunodeficiency virus (HlV)-positive mother can reduce transmission of the infection to the fetus by more than two thirds, it is obvious that identification of HIV-positive mothers is essential. Although HIV testing cannot be required of
*Disparity between the size of the maternal pelvis and the fetal head, which precludes vaginal delivery.
the mother, it is mandatory that she be counseled about the value of testing. Screening for HIV is routinely offered and is usually (90%) accepted. A history of genital herpes simplex necessitates screening for recurrences near the time of delivery, because cesarean delivery may be necessary to prevent transmission to the neonate. Screening for gonorrhea is performed in high-risk populations.
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