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A 28-Year-Old Woman, Gravida 1, Para 0, at 32 Weeks

Question 312

Multiple Choice

A 28-year-old woman, gravida 1, para 0, at 32 weeks' gestation comes to the physician for a prenatal visit. She has had no prenatal care. She emigrated from China 5 years ago and cannot recall all of her vaccinations. She appears well. Physical examination shows a uterus consistent in size with a 32-week gestation. Serum studies show:
Anti-hepatitis A IgM antibody negative
Anti-hepatitis A IgG antibody positive
Hepatitis B surface antigen negative
Anti-hepatitis B surface antibody positive
Hepatitis B core antigen negative
Anti-hepatitis B core antibody negative
Which of the following is the most appropriate initial action by the physician?


A) Plan vaginal delivery at term
B) Determine the hepatitis B envelope antigen serum level
C) Plan to give hepatitis B immunoglobulin to the newborn
D) dminister hepatitis B vaccine to the mother
E) Advise the patient to avoid breastfeeding

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