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ACOG COMMITTEE OPINION

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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
#1
(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
#2
(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
#3
(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
#4
(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
#5
(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
https://www.readbyqxmd.com/read/30045210/acog-committee-opinion-no-744-value-based-payments-in-obstetrics-and-gynecology
#6
(no author information available yet)
Unsustainable health care costs combined with suboptimal patient outcomes have led health policy experts and payers to consider value-based payment or alternative payment models. Replacing fee-for-service reimbursement, these models link payment to value by rewarding efforts to enhance the quality of care at similar or reduced costs. Although many of the models employed to date have focused on primary care, management of chronic disease in the Medicare population, and episodes of care for common procedures, models for primary and specialty care of women are in the early stages of development...
August 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/30045209/acog-committee-opinion-no-749-summary-marriage-and-family-building-equality-for-lesbian-gay-bisexual-transgender-queer-intersex-asexual-and-gender-nonconforming-individuals
#7
(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/30045208/acog-committee-opinion-no-748-summary-the-importance-of-vital-records-and-statistics-for-the-obstetrician-gynecologist
#8
(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/30045207/acog-committee-opinion-no-747-summary-gynecologic-issues-in-children-and-adolescent-cancer-patients-and-survivors
#9
(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/30045206/acog-committee-opinion-no-746-summary-air-travel-during-pregnancy
#10
(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/30045205/acog-committee-opinion-no-745-summary-mode-of-term-singleton-breech-delivery
#11
(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
https://www.readbyqxmd.com/read/30045204/acog-committee-opinion-no-744-summary-value-based-payments-in-obstetrics-and-gynecology
#12
(no author information available yet)
Unsustainable health care costs combined with suboptimal patient outcomes have led health policy experts and payers to consider value-based payment or alternative payment models. Replacing fee-for-service reimbursement, these models link payment to value by rewarding efforts to enhance the quality of care at similar or reduced costs. Although many of the models employed to date have focused on primary care, management of chronic disease in the Medicare population, and episodes of care for common procedures, models for primary and specialty care of women are in the early stages of development...
August 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29939940/acog-committee-opinion-no-743-low-dose-aspirin-use-during-pregnancy
#13
(no author information available yet)
Low-dose aspirin has been used during pregnancy, most commonly to prevent or delay the onset of preeclampsia. The American College of Obstetricians and Gynecologists issued the Hypertension in Pregnancy Task Force Report recommending daily low-dose aspirin beginning in the late first trimester for women with a history of early-onset preeclampsia and preterm delivery at less than 34 0/7 weeks of gestation, or for women with more than one prior pregnancy complicated by preeclampsia. The U.S. Preventive Services Task Force published a similar guideline, although the list of indications for low-dose aspirin use was more expansive...
July 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29939936/acog-committee-opinion-no-743-summary-low-dose-aspirin-use-during-pregnancy
#14
(no author information available yet)
Low-dose aspirin has been used during pregnancy, most commonly to prevent or delay the onset of preeclampsia. The American College of Obstetricians and Gynecologists issued the Hypertension in Pregnancy Task Force Report recommending daily low-dose aspirin beginning in the late first trimester for women with a history of early-onset preeclampsia and preterm delivery at less than 34 0/7 weeks of gestation, or for women with more than one prior pregnancy complicated by preeclampsia. The U.S. Preventive Services Task Force published a similar guideline, although the list of indications for low-dose aspirin use was more expansive...
July 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29939935/acog-committee-opinion-no-742-summary-postpartum-pain-management
#15
(no author information available yet)
Pain and fatigue are the most common problems reported by women in the early postpartum period. Pain can interfere with a woman's ability to care for herself and her infant. Untreated pain is associated with a risk of greater opioid use, postpartum depression, and development of persistent pain. Nonpharmacologic and pharmacologic therapies are important components of postpartum pain management. Because 81% of women in the United States initiate breastfeeding during the postpartum period, it is important to consider the drug effects of all prescribed medications on the mother-infant dyad...
July 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29794683/acog-committee-opinion-no-741-maternal-immunization
#16
(no author information available yet)
Immunization is an essential part of care for adults, including pregnant women. Influenza vaccination for pregnant women is especially important because pregnant women who contract influenza are at greater risk of maternal morbidity and mortality in addition to fetal morbidity, including congenital anomalies, spontaneous abortion, preterm birth, and low birth weight. Other vaccines provide maternal protection from severe morbidity related to specific pathogens such as pneumococcus, meningococcus, and hepatitis for at-risk pregnant women...
June 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29794682/acog-committee-opinion-no-740-gynecologic-care-for-adolescents-and-young-women-with-eating-disorders
#17
(no author information available yet)
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, defines eating disorders as a "persistent disturbance of eating or eating-related behavior that results in the altered consumption or absorption of food and that significantly impairs physical health or psychosocial functioning." The correct diagnosis of and distinction between eating disorders are important because the course, prognosis, and treatment may be vastly different. Although the age at peak incidence can vary depending on the eating disorder, these disorders commonly arise during adolescence...
June 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29794681/acog-committee-opinion-no-739-the-late-career-obstetrician-gynecologist
#18
(no author information available yet)
The American Medical Association reported in 2015 that physicians 65 years and older currently represent 23% of the physicians in the United States. Unlike other professions such as commercial airline pilots, who by law must have regular health screenings starting at 40 years and must retire at 65 years, few health care institutions or systems have any policies regarding the late-career physician. Although there is an increase in accumulated wisdom and verbal knowledge with age, there is also an overall decline in recall memory, cognitive processing efficiency, and executive reasoning...
June 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29794680/acog-committee-opinion-no-738-aromatase-inhibitors-in-gynecologic-practice
#19
(no author information available yet)
Aromatase inhibitors have been used for the treatment of breast cancer, ovulation induction, endometriosis, and other estrogen-modulated conditions. For women with breast cancer, bone mineral density screening is recommended with long-term aromatase inhibitor use because of the risk of osteoporosis due to estrogen deficiency. Based on long-term adverse effects and complication safety data, when compared with tamoxifen, aromatase inhibitors are associated with a reduced incidence of thrombosis, endometrial cancer, and vaginal bleeding...
June 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29794679/acog-committee-opinion-no-737-expedited-partner-therapy
#20
(no author information available yet)
Sexually transmitted infections (STIs) disproportionately affect women and create a preventable threat to their fertility. One factor that contributes to young women's high rates of STIs is reinfection from an untreated sexual partner. One way to address this problem is through expedited partner therapy, the practice of treating the sexual partners of patients in whom STIs are diagnosed. Expedited partner therapy enables the obstetrician-gynecologist or other provider to give prescriptions or medications to patients to take to their partners without first examining these partners...
June 2018: Obstetrics and Gynecology
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