Which of the following ages is the anticipated gestational age of the fetus for a client in active labor on December 26 who reports their last menstrual period was around April 1?

Choice A reason: Transmission of HSV-2 to the newborn is higher with active lesions at birth, as direct contact during vaginal delivery increases neonatal herpes risk. The virus can cause severe neonatal infections, affecting the central nervous system. Cesarean delivery is often recommended to reduce transmission, per obstetric virology guidelines.

Choice B reason: Antiviral medications like acyclovir suppress HSV-2 symptoms and reduce transmission but do not cure the condition, as the virus remains latent in nerve ganglia. Chronic management is required, and this statement misrepresents the virological nature of herpes, which persists lifelong despite treatment, per infectious disease principles.

Choice C reason: Wearing tight-fitting undergarments during HSV-2 lesions is not recommended, as it may cause irritation, delaying healing. Loose clothing minimizes friction, supporting lesion recovery. This advice does not address viral transmission or fetal risk, focusing on comfort rather than the virological or obstetric management of HSV-2.

Choice D reason: HSV-2 can harm the fetus, especially with primary infection, causing congenital herpes, preterm birth, or neurological damage. While rare, transplacental transmission or exposure during delivery poses risks. This statement is incorrect, as HSV-2’s potential for fetal harm necessitates careful management, per perinatal infection guidelines.

Choice A reason: Stating that rubella vaccination prevents breastfeeding is incorrect. The rubella vaccine, a live-attenuated virus, is safe for postpartum administration in non-immune mothers, as it does not significantly excrete in breast milk or harm the infant. Breastfeeding supports neonatal immunity through maternal antibodies, and this statement misrepresents vaccine safety and breastfeeding physiology.

Choice B reason: Repeating a rubella titer in the third trimester is unnecessary unless new exposure is suspected. A titer of 1:8 indicates susceptibility, requiring postpartum immunization, not repeated testing. Serological testing monitors antibody levels, but rubella immunity status typically remains stable during pregnancy unless infection occurs, making routine retesting scientifically unjustified in this context.

Choice C reason: Administering rubella immunization during pregnancy is contraindicated, as it is a live vaccine that poses a theoretical risk to the fetus. A titer of 1:8 indicates susceptibility, warranting postpartum vaccination. The immune system’s response to live vaccines could potentially cross the placenta, affecting fetal development, so immunization is deferred until after delivery.

Choice D reason: A rubella titer of 1:8 indicates susceptibility, as titers below 1:10 suggest insufficient antibodies to confer immunity. Rubella infection during pregnancy can cause congenital rubella syndrome, leading to fetal anomalies. This statement accurately reflects the need for postpartum immunization to protect future pregnancies, aligning with serological evidence and prenatal care guidelines.