For which infections should a pregnant woman be tested?

Raj. CHO -2020

Obstetrics & Gynaecology

Easy

Appeared in: Raj. CHO -2020

Explanation

Routine antenatal screening focuses on infections that can be transmitted from mother to child (vertical transmission) and for which effective interventions exist to protect the newborn.
The standard universal screening panel recommended by major health organizations (like the CDC) for all pregnant women includes HIV, Hepatitis B (HBV), and Syphilis.
Testing for HIV allows for antiretroviral therapy to prevent transmission.
Testing for Hepatitis B surface antigen (HBsAg) ensures the newborn receives the vaccine and immune globulin at birth.
Testing for Syphilis allows for maternal treatment with penicillin to prevent severe complications of congenital syphilis in the infant.

Option A: Hepatitis A is not part of the routine universal screening panel for pregnant women.
Option C: While recommendations are evolving, Hepatitis C screening has traditionally been based on risk factors (e.g., history of IV drug use) rather than being a universal requirement for all pregnant women.
Option D: Hepatitis E is not part of the standard antenatal screening panel.

Visual 1: Infographic: The 'Big 3' Antenatal Screening Tests. Shows icons for HIV, Hepatitis B, and Syphilis, with brief text on why each test is vital for preventing mother-to-child transmission and the specific intervention for each.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Routine antenatal screening for infectious diseases as background academic context rather than a clinical decision trigger.
The nurse's role is crucial in patient education, explaining the importance of these tests for the baby's health, obtaining informed consent, and providing non-judgmental counseling and support if a test result is positive.
Early and consistent prenatal care is essential for ensuring these screenings are performed in a timely manner, allowing for prompt intervention.
What if? If a patient refuses screening, the nurse must document the refusal after ensuring the patient understands the potential risks to the newborn. The nurse's duty is to provide information and respect patient autonomy, while also re-offering the tests at subsequent visits.

How to Approach the Question

Identify the core of the question, which is asking about routine or standard infection screening for all pregnant women.
Recall the primary goal of antenatal infectious disease screening: to prevent vertical transmission (mother-to-child) of serious diseases.
Focus on the infections that have well-established, effective interventions to protect the newborn if the mother is positive.
The three cornerstone infections that fit this criteria are HIV (preventable with ART), Hepatitis B (preventable with newborn vaccine/HBIG), and Syphilis (preventable with maternal penicillin treatment).
Scan the options to find the one that contains this exact combination of three infections.
Eliminate options containing Hepatitis A and E, as these are transmitted differently and are not part of routine screening. Also, be aware that Hepatitis C screening is often risk-based, making the option with Hepatitis B the most universally correct answer.

Concept Tested & Keywords

Concept Tested: Routine antenatal screening for infectious diseases.
Stem keywords: pregnant woman, infections, tested
Lead-in keywords: For which
Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.
Negative lead-in flag: false

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