What is the recommended management for a pregnant woman with AIDS?

The recommended management for a pregnant woman with AIDS includes elective cesarean section at 36 weeks and the continuation of antiretroviral therapy. This approach is based on the understanding that HIV can be transmitted from mother to child during vaginal delivery, particularly when the viral load is not adequately controlled.

By opting for a scheduled cesarean section before the onset of labor, the risk of vertical transmission of HIV can be significantly reduced, especially when combined with effective antiretroviral therapy. Managing the mother's viral load through ART contributes to lower transmission rates and improves maternal health, making this option comprehensive and well-supported by clinical guidelines.

Natural delivery without any medication does not provide the same level of risk reduction for HIV transmission, and waiting for labor to start poses a higher risk if the viral load is not adequately suppressed. Regular monitoring without intervention does not address the key risks associated with HIV transmission during childbirth. Initiating ART during labor is not sufficient to manage the viral load effectively, as optimal outcomes depend on pre-labor management of the mother's condition.

In this context, the combination of cesarean delivery and pre-labor initiation or continuation of antiretroviral therapy is the most effective strategy to ensure the health of both the mother and the child