What prophylactic treatment is initiated at 36 weeks for women positive for HSV?

The initiation of prophylactic acyclovir at 36 weeks of gestation for women who are positive for herpes simplex virus (HSV) is based on the understanding of preventing neonatal herpes transmission during delivery. Pregnant women with a history of genital herpes are at risk for outbreaks around the time of delivery, which could potentially expose the newborn to HSV, leading to serious health complications.

Acyclovir is an antiviral medication effective against HSV, and starting this treatment in the late third trimester can help reduce the incidence of herpetic lesions at the time of labor, thereby lowering the risk of transmission to the infant. The recommendation is particularly crucial for women who have recurrent herpes outbreaks or have had prior outbreaks during the pregnancy.

Other treatments listed — such as IV antibiotics and insulin therapy — are not appropriate in this scenario. Antibiotics are used for bacterial infections and would not prevent viral transmission, while insulin therapy is related to the management of diabetes, which does not pertain to HSV. The option of "none" implies that no prophylactic measures are taken, which does not align with current guidelines aiming to protect both the mother and the newborn from potential complications associated with HSV. Thus, the initiation of prophylactic acyclovir is a well-supported clinical practice in