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ACOG COMMITTEE OPINION

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https://www.readbyqxmd.com/read/30247365/acog-committee-opinion-no-756-optimizing-support-for-breastfeeding-as-part-of-obstetric-practice
#1
(no author information available yet)
As reproductive health experts and advocates for women's health who work in conjunction with other obstetric and pediatric health care providers, obstetrician-gynecologists are uniquely positioned to enable women to achieve their infant feeding goals. Maternity care policies and practices that support breastfeeding are improving nationally; however, more work is needed to ensure all women receive optimal breastfeeding support during prenatal care, during their maternity stay, and after the birth occurs. Enabling women to breastfeed is a public health priority because, on a population level, interruption of lactation is associated with adverse health outcomes for the woman and her child, including higher maternal risks of breast cancer, ovarian cancer, diabetes, hypertension, and heart disease, and greater infant risks of infectious disease, sudden infant death syndrome, and metabolic disease...
October 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/30247364/acog-committee-opinion-no-755-well-woman-visit
#2
(no author information available yet)
A well-woman visit provides an excellent opportunity to counsel patients about maintaining a healthy lifestyle and minimizing health risks. Given the shifting and complex landscape of care, in which many women may not receive all the recommended preventive services, obstetrician-gynecologists have an opportunity to contribute to the overall health and well-being of women throughout the lifespan by providing recommended preventive services and counseling. Taking a comprehensive history (specifically obtaining detailed information on symptoms and past medical and gynecologic history) will inform if certain components of the physical examination, including breast or pelvic examination, are indicated at that visit and will inform shared decision making for these examinations...
October 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/30247363/acog-committee-opinion-no-754-the-utility-of-and-indications-for-routine-pelvic-examination
#3
(no author information available yet)
The pelvic examination has long been considered a fundamental component of the well-woman visit, and many women and gynecologic care providers view this visit as an opportunity to discuss sexual and reproductive health issues. Traditionally, a pelvic examination is performed for asymptomatic women as a screening tool for gynecologic cancer, infection, and asymptomatic pelvic inflammatory disease; some obstetrician-gynecologists and patients consider it important in detecting subclinical disease, despite evidence to the contrary...
October 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/30247362/acog-committee-opinion-no-753-assessment-and-treatment-of-pregnant-women-with-suspected-or-confirmed-influenza
#4
(no author information available yet)
Pregnant and postpartum women are at high risk of serious complications of seasonal and pandemic influenza infection. Pregnancy itself is a high-risk condition, making the potential adverse effects of influenza particularly serious in pregnant women. If a pregnant woman has other underlying health conditions, the risk of adverse effects from influenza is even greater. Antiviral treatment is necessary for all pregnant women with suspected or confirmed influenza, regardless of vaccination status. Obstetrician-gynecologists and other obstetric care providers should promptly recognize the symptoms of influenza, adequately assess severity, and readily prescribe safe and effective antiviral therapy for pregnant women with suspected or confirmed influenza...
October 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/30247361/acog-committee-opinion-no-756-summary-optimizing-support-for-breastfeeding-as-part-of-obstetric-practice
#5
(no author information available yet)
As reproductive health experts and advocates for women's health who work in conjunction with other obstetric and pediatric health care providers, obstetrician-gynecologists are uniquely positioned to enable women to achieve their infant feeding goals. Maternity care policies and practices that support breastfeeding are improving nationally; however, more work is needed to ensure all women receive optimal breastfeeding support during prenatal care, during their maternity stay, and after the birth occurs. Enabling women to breastfeed is a public health priority because, on a population level, interruption of lactation is associated with adverse health outcomes for the woman and her child, including higher maternal risks of breast cancer, ovarian cancer, diabetes, hypertension, and heart disease, and greater infant risks of infectious disease, sudden infant death syndrome, and metabolic disease...
October 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/30247360/acog-committee-opinion-no-755-summary-well-woman-visit
#6
(no author information available yet)
A well-woman visit provides an excellent opportunity to counsel patients about maintaining a healthy lifestyle and minimizing health risks. Given the shifting and complex landscape of care, in which many women may not receive all the recommended preventive services, obstetrician-gynecologists have an opportunity to contribute to the overall health and well-being of women throughout the lifespan by providing recommended preventive services and counseling. Taking a comprehensive history (specifically obtaining detailed information on symptoms and past medical and gynecologic history) will inform if certain components of the physical examination, including breast or pelvic examination, are indicated at that visit and will inform shared decision making for these examinations...
October 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/30247359/acog-committee-opinion-no-754-summary-the-utility-of-and-indications-for-routine-pelvic-examination
#7
(no author information available yet)
The pelvic examination has long been considered a fundamental component of the well-woman visit, and many women and gynecologic care providers view this visit as an opportunity to discuss sexual and reproductive health issues. Traditionally, a pelvic examination is performed for asymptomatic women as a screening tool for gynecologic cancer, infection, and asymptomatic pelvic inflammatory disease; some obstetrician-gynecologists and patients consider it important in detecting subclinical disease, despite evidence to the contrary...
October 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/30247358/acog-committee-opinion-no-753-summary-assessment-and-treatment-of-pregnant-women-with-suspected-or-confirmed-influenza
#8
(no author information available yet)
Pregnant and postpartum women are at high risk of serious complications of seasonal and pandemic influenza infection. Pregnancy itself is a high-risk condition, making the potential adverse effects of influenza particularly serious in pregnant women. If a pregnant woman has other underlying health conditions, the risk of adverse effects from influenza is even greater. Antiviral treatment is necessary for all pregnant women with suspected or confirmed influenza, regardless of vaccination status. Obstetrician-gynecologists and other obstetric care providers should promptly recognize the symptoms of influenza, adequately assess severity, and readily prescribe safe and effective antiviral therapy for pregnant women with suspected or confirmed influenza...
October 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/30134428/acog-committee-opinion-no-752-prenatal-and-perinatal-human-immunodeficiency-virus-testing
#9
(no author information available yet)
Given the enormous advances in the prevention of perinatal transmission of human immunodeficiency virus (HIV), it is clear that early identification and treatment of all pregnant women with HIV is the best way to prevent neonatal infection and also improve women's health. Furthermore, new evidence suggests that early initiation of antiretroviral therapy in the course of infection is beneficial for individuals infected with HIV and reduces the rate of sexual transmission to partners who are not infected. Screening should be performed after women have been notified that HIV screening is recommended for all pregnant patients and that they will receive an HIV test as part of the routine panel of prenatal tests unless they decline (opt-out screening)...
September 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/30134427/acog-committee-opinion-no-751-labor-and-delivery-management-of-women-with-human-immunodeficiency-virus-infection
#10
(no author information available yet)
This Committee Opinion is being revised to provide updated guidance on the management of pregnant women during pregnancy and delivery to prevent mother-to-child transmission of the human immunodeficiency virus (HIV). Prevention of transmission of HIV from the woman to her fetus or newborn is a major goal in the care of pregnant women infected with HIV. Continuing research into mother-to-child transmission of HIV has suggested that a substantial number of cases of perinatal HIV transmission occur as the result of fetal exposure to the virus during labor and delivery...
September 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/30134426/acog-committee-opinion-no-750-perioperative-pathways-enhanced-recovery-after-surgery
#11
(no author information available yet)
Gynecologic surgery is very common: hysterectomy alone is one of the most frequently performed operating room procedures each year. It is well known that surgical stress induces a catabolic state that leads to increased cardiac demand, relative tissue hypoxia, increased insulin resistance, impaired coagulation profiles, and altered pulmonary and gastrointestinal function. Enhanced Recovery After Surgery (ERAS) pathways were developed with the goal of maintaining normal physiology in the perioperative period, thus optimizing patient outcomes without increasing postoperative complications or readmissions...
September 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/30134421/acog-committee-opinion-no-752-summary-prenatal-and-perinatal-human-immunodeficiency-virus-testing
#12
(no author information available yet)
Given the enormous advances in the prevention of perinatal transmission of human immunodeficiency virus (HIV), it is clear that early identification and treatment of all pregnant women with HIV is the best way to prevent neonatal infection and also improve women's health. Furthermore, new evidence suggests that early initiation of antiretroviral therapy in the course of infection is beneficial for individuals infected with HIV and reduces the rate of sexual transmission to partners who are not infected. Screening should be performed after women have been notified that HIV screening is recommended for all pregnant patients and that they will receive an HIV test as part of the routine panel of prenatal tests unless they decline (opt-out screening)...
September 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/30134420/acog-committee-opinion-no-751-summary-labor-and-delivery-management-ofwomenwith-human-immunodeficiency-virus-infection
#13
(no author information available yet)
This Committee Opinion is being revised to provide updated guidance on the management of pregnant women during pregnancy and delivery to prevent mother-to-child transmission of the human immunodeficiency virus (HIV). Prevention of transmission of HIV from the woman to her fetus or newborn is a major goal in the care of pregnant women infected with HIV. Continuing research into mother-to-child transmission of HIV has suggested that a substantial number of cases of perinatal HIV transmission occur as the result of fetal exposure to the virus during labor and delivery...
September 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/30134419/acog-committee-opinion-no-750-summary-perioperative-pathways-enhanced-recovery-after-surgery
#14
(no author information available yet)
Gynecologic surgery is very common: hysterectomy alone is one of the most frequently performed operating room procedures each year. It is well known that surgical stress induces a catabolic state that leads to increased cardiac demand, relative tissue hypoxia, increased insulin resistance, impaired coagulation profiles, and altered pulmonary and gastrointestinal function. Enhanced Recovery After Surgery (ERAS) pathways were developed with the goal of maintaining normal physiology in the perioperative period, thus optimizing patient outcomes without increasing postoperative complications or readmissions...
September 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/30134408/acog-committee-opinion-no-736-optimizing-postpartum-care
#15
Jessica McKinney, Laura Keyser, Susan Clinton, Carrie Pagliano
No abstract text is available yet for this article.
September 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/30045215/acog-committee-opinion-no-749-marriage-and-family-building-equality-for-lesbian-gay-bisexual-transgender-queer-intersex-asexual-and-gender-nonconforming-individuals
#16
(no author information available yet)
The American College of Obstetricians and Gynecologists reaffirms its support of unrestricted access to legal marriage for all adults. The American College of Obstetricians and Gynecologists believes that no matter how a child comes into a family, all children and parents deserve equitable protections and access to available resources to maximize the health of that family unit. Obstetrician-gynecologists should recognize the diversity in parenting desires that exists in the lesbian, gay, bisexual, transgender, queer, intersex, asexual, and gender nonconforming communities and should take steps to ensure that clinical spaces are affirming and open to all patients, such that equitable and comprehensive, reproductive health care can meet the needs of these communities...
August 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/30045214/acog-committee-opinion-no-748-the-importance-of-vital-records-and-statistics-for-the-obstetrician-gynecologist
#17
(no author information available yet)
Information from vital records is critical to identify and quantify health-related issues and to measure progress toward quality improvement and public health goals. In particular, maternal and infant mortality serve as important indicators of the nation's health, thereby influencing policy development, funding of programs and research, and measures of health care quality. Accurate and timely documentation of births and deaths is essential to high-quality vital statistics. This Committee Opinion describes the process by which births, maternal deaths, and fetal deaths are registered; the challenges faced with a decentralized reporting system; and the important role for obstetrician-gynecologists in improving the accuracy, reliability, and timeliness of vital records...
August 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/30045213/acog-committee-opinion-no-747-gynecologic-issues-in-children-and-adolescent-cancer-patients-and-survivors
#18
(no author information available yet)
The diagnosis of cancer in females younger than 20 years is rare, with the incidence of 17 cases per 100,000 individuals per year in the United States. Although advancements in cancer therapy have dramatically improved childhood cancer survival, gynecologists should be aware of the increased risk of adverse reproductive health effects from each type of therapy. Cancer and its treatment may have immediate or delayed adverse effects on reproductive health. Gynecologists may be consulted for the following issues: pubertal concerns; menstrual irregularities; heavy menstrual bleeding and anemia; sexuality; contraception; ovarian function, including fertility preservation; breast and cervical cancer screening; hormone therapy; and graft-versus-host disease...
August 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/30045212/acog-committee-opinion-no-746-air-travel-during-pregnancy
#19
(no author information available yet)
In the absence of obstetric or medical complications, occasional air travel is safe for pregnant women. Pregnant women can fly safely, observing the same precautions for air travel as the general population. Because severe air turbulence cannot be predicted and the subsequent risk for trauma is significant should this occur, pregnant women should be instructed to use their seat belts continuously while seated. Despite a lack of evidence associating lower extremity edema and venous thrombotic events with air travel during pregnancy, certain preventive measures can be used to minimize these risks, including use of support stockings and periodic movement of the lower extremities, avoidance of restrictive clothing, occasional ambulation, and maintenance of adequate hydration...
August 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/30045211/acog-committee-opinion-no-745-mode-of-term-singleton-breech-delivery
#20
(no author information available yet)
There is a trend in the United States to perform cesarean delivery for term singleton fetuses in a breech presentation. The number of practitioners with the skills and experience to perform vaginal breech delivery has decreased. The decision regarding the mode of delivery should consider patient wishes and the experience of the health care provider. Obstetrician-gynecologists and other obstetric care providers should offer external cephalic version as an alternative to planned cesarean for a woman who has a term singleton breech fetus, desires a planned vaginal delivery of a vertex-presenting fetus, and has no contraindications...
August 2018: Obstetrics and Gynecology
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