Recommendations were not based on cost-effectiveness of options. Patient preferences were not discussed. Background papers providing critical appraisal of the evidence and tentative recommendations prepared by the chapter author were pre-circulated to the members. Consensus was reached on final recommendations. Benefits, Harms, and Costs History taking to identify women who are at high risk of transmission is unreliable.
Patients are often unaware of their previous active infections.
Although it is accurate, the cervical smear culture takes 3 days to complete and therefore is not useful for making decisions for women in labour. In these cases, the penultimate culture result is used, but this has very low predictive validity for the presence of infection at the time of delivery. Approximately 30 excess cesarean sections would be done for each case prevented. Strategies involving screening of high-risk women would require 36 to 178 extra cesarean sections per case averted. Citations in support of individual recommendations are identified in the guideline text.