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https://www.readbyqxmd.com/read/30258507/management-of-chronic-and-gestational-hypertension-of-pregnancy-a-guide-for-primary-care-nurse-practitioners
#1
REVIEW
Leah Spiro, Donna Scemons
Aim: The aim of this discussion paper is to outline the guidelines, according to the American Congress of Obstetricians and Gynecologists, about how to manage hypertension before and during pregnancy. Primary providers lack the knowledge to initiate treatment and manage hypertension in patients who are family planning or in the early stages of pregnancy before transferring care to an obstetrician, or perhaps patients who never do transfer care for lack of accessibility or funding. This paper aims to discuss how the Family Nurse Practitioner, or other primary care providers, may safely and efficiently maintain stable blood pressures in patients with hypertension before, during, and after pregnancy...
2018: Open Nursing Journal
https://www.readbyqxmd.com/read/30253316/likelihood-of-cesarean-birth-among-parous-women-after-applying-leading-active-labor-diagnostic-guidelines
#2
Jeremy L Neal, Nancy K Lowe, Julia C Phillippi, Nicole S Carlson, Amy M Knupp, Mary S Dietrich
OBJECTIVES: Hospital admission during early labor may increase women's risk for medical and surgical interventions. However, it is unclear which diagnostic guideline is best suited for identifying the active phase of labor among parous women. Dr. Emanuel Friedman, the United Kingdom's National Institute for Health and Care Excellence (NICE), and the American College of Obstetricians and Gynecologists/Society for Maternal-Fetal Medicine (ACOG/SMFM) support different active labor diagnostic guidelines...
September 11, 2018: Midwifery
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/30247359/acog-committee-opinion-no-754-summary-the-utility-of-and-indications-for-routine-pelvic-examination
#4
(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/30185092/outcomes-associated-with-trial-of-labor-after-cesarean-in-women-with-one-versus-two-prior-cesarean-deliveries-after-a-change-in-clinical-practice-guidelines-in-an-academic-hospital
#5
Christina Davidson, Patricia Bellows, Utsavi Shah, Lauren Hawley, Kathleen Drexler, Manisha Gandhi, Catherine Eppes, Haleh Sangi-Haghpeykar
OBJECTIVE: In 2010, the American College of Obstetricians & Gynecologists (ACOG) published a new clinical practice guideline on trial of labor after cesarean (TOLAC) that was considered less restrictive. It allowed for offering TOLAC to women with two prior cesarean deliveries, even without a prior vaginal delivery, and for labor induction. As a result, our hospital, a public tertiary care academic center, updated our TOLAC practice guideline to reflect ACOG's new recommendations...
September 5, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/30134425/acog-practice-bulletin-no-199-use-of-prophylactic-antibiotics-in-labor-and-delivery
#6
(no author information available yet)
The use of antibiotics to prevent infections during the antepartum, intrapartum, and postpartum periods is different than the use of antibiotics to treat established infections. For many years, the use of prophylactic antibiotics was thought to have few adverse consequences. Concerns about the emergence of resistant strains of common bacteria, in addition to the emergence of strains with increased virulence, have resulted in increased scrutiny of the use of antibiotics, particularly in the hospital setting...
September 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/30134424/acog-practice-bulletin-no-198-prevention-and-management-of-obstetric-lacerations-at-vaginal-delivery
#7
(no author information available yet)
Lacerations are common after vaginal birth. Trauma can occur on the cervix, vagina, and vulva, including the labial, periclitoral, and periurethral regions, and the perineum. Most of these lacerations do not result in adverse functional outcomes. Severe perineal lacerations, extending into or through the anal sphincter complex, although less frequent, are more commonly associated with increased risk of pelvic floor injury, fecal and urinary incontinence, pain, and sexual dysfunction with symptoms that may persist or be present many years after giving birth...
September 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/30134418/acog-practice-bulletin-no-199-summary-use-of-prophylactic-antibiotics-in-labor-and-delivery
#8
(no author information available yet)
The use of antibiotics to prevent infections during the antepartum, intrapartum, and postpartum periods is different than the use of antibiotics to treat established infections. For many years, the use of prophylactic antibiotics was thought to have few adverse consequences. Concerns about the emergence of resistant strains of common bacteria, in addition to the emergence of strains with increased virulence, have resulted in increased scrutiny of the use of antibiotics, particularly in the hospital setting...
September 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/30134417/acog-practice-bulletin-no-198-summary-prevention-and-management-of-obstetric-lacerations-at-vaginal-delivery
#9
(no author information available yet)
Lacerations are common after vaginal birth. Trauma can occur on the cervix, vagina, and vulva, including the labial, periclitoral, and periurethral regions, and the perineum. Most of these lacerations do not result in adverse functional outcomes. Severe perineal lacerations, extending into or through the anal sphincter complex, although less frequent, are more commonly associated with increased risk of pelvic floor injury, fecal and urinary incontinence, pain, and sexual dysfunction with symptoms that may persist or be present many years after giving birth...
September 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/30045211/acog-committee-opinion-no-745-mode-of-term-singleton-breech-delivery
#10
(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/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/29940314/noncytotoxic-related-primary-ovarian-insufficiency-in-adolescents-multicenter-case-series-and-review
#12
Lauren Kanner, Julie C E Hakim, Christina Davis Kankanamge, Vrunda Patel, Vivian Yu, Emily Podany, Veronica Gomez-Lobo
STUDY OBJECTIVE: Primary ovarian insufficiency (POI) in adolescents not due to cytotoxic therapy has not been well studied. Causes of POI have been described in adults, but adolescents might represent a unique subset necessitating a targeted approach to diagnosis, workup, and treatment. We sought to better characterize adolescent POI through a descriptive multicenter study. DESIGN: Case series of patients with POI. SETTING: Six tertiary care institutions...
June 27, 2018: Journal of Pediatric and Adolescent 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/29939939/acog-practice-bulletin-no-197-inherited-thrombophilias-in-pregnancy
#14
(no author information available yet)
Inherited thrombophilias are associated with an increased risk of venous thromboembolism and have been linked to adverse outcomes in pregnancy. However, there is limited evidence to guide screening for and management of these conditions in pregnancy. The purpose of this document is to review common thrombophilias and their association with maternal venous thromboembolism risk and adverse pregnancy outcomes, indications for screening to detect these conditions, and management options in pregnancy. This Practice Bulletin has been revised to provide additional information on recommendations for candidates for thrombophilia evaluation, updated consensus guidelines regarding the need for prophylaxis in women with an inherited thrombophilia during pregnancy and the postpartum period, and discussion of new published consensus guidelines from the Society for Obstetric Anesthesia and Perinatology addressing thromboprophylaxis and neuraxial anesthetic considerations in the obstetric population...
July 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29939936/acog-committee-opinion-no-743-summary-low-dose-aspirin-use-during-pregnancy
#15
(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/29939934/acog-practice-bulletin-no-197-summary-inherited-thrombophilias-in-pregnancy
#16
(no author information available yet)
Inherited thrombophilias are associated with an increased risk of venous thromboembolism and have been linked to adverse outcomes in pregnancy. However, there is limited evidence to guide screening for and management of these conditions in pregnancy. The purpose of this document is to review common thrombophilias and their association with maternal venous thromboembolism risk and adverse pregnancy outcomes, indications for screening to detect these conditions, and management options in pregnancy. This Practice Bulletin has been revised to provide additional information on recommendations for candidates for thrombophilia evaluation, updated consensus guidelines regarding the need for prophylaxis in women with an inherited thrombophilia during pregnancy and the postpartum period, and discussion of new published consensus guidelines from the Society for Obstetric Anesthesia and Perinatology addressing thromboprophylaxis and neuraxial anesthetic considerations in the obstetric population...
July 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29861243/pilates-program-design-and-health-benefits-for-pregnant-women-a-practitioners-survey
#17
Melissa Mazzarino, Debra Kerr, Meg E Morris
BACKGROUND: Little is known about recommendations for safe and appropriate instruction of Pilates exercises to women during pregnancy. The aim of this study was to examine Pilates practitioners' perspectives regarding Pilates program design for pregnant women. We also sought to elucidate their views on the potential benefits, restrictions and contraindications on Pilates in pregnancy. METHODS: A cross-sectional survey was performed. Pilates practitioners were invited to participate via email...
April 2018: Journal of Bodywork and Movement Therapies
https://www.readbyqxmd.com/read/29799155/listeria-then-and-now-a-call-to-reevaluate-patient-teaching-based-on-analysis-of-us-federal-databases-1998-2016
#18
Katya Simon, Valentina Simon, Rachel Rosenzweig, Rebeca Barroso, Mickey Gillmor-Kahn
INTRODUCTION: Listeria monocytogenes is a foodborne pathogen capable of crossing the placental-fetal barrier; infection with the bacterium causes listeriosis. An exposed fetus may suffer blindness, neurological damage including meningitis, or even death. The adverse consequences of listeriosis place the infection on the federally reportable disease list. Primary prevention relies on women avoiding 6 categories of foods most likely to be contaminated with L monocytogenes, as indicated in guidelines developed by the Centers for Disease Control and Prevention (CDC), adapted by the American College of Obstetricians and Gynecologists (ACOG) in 2014, and reaffirmed without changes by ACOG in 2016...
May 2018: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/29733840/-doing-something-about-the-cesarean-delivery-rate
#19
Steven L Clark, Thomas J Garite, Emily F Hamilton, Michael A Belfort, G D Hankins
There is a general consensus that the cesarean delivery rate in the United States is too high, and that practice patterns of obstetricians are largely to blame for this situation. In reality, the US cesarean delivery rate is the result of 3 forces largely beyond the control of the practicing clinician: patient expectations and misconceptions regarding the safety of labor, the medical-legal system, and limitations in technology. Efforts to "do something" about the cesarean delivery rate by promulgating practice directives that are marginally evidence-based or influenced by social pressures are both ineffective and potentially harmful...
September 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29703800/comparing-standard-office-based-follow-up-with-text-based-remote-monitoring-in-the-management-of-postpartum-hypertension-a-randomised-clinical-trial
#20
Adi Hirshberg, Katheryne Downes, Sindhu Srinivas
BACKGROUND: Monitoring blood pressure at 72 hours and 7-10 days post partum in women with hypertensive disorders is recommended to decrease morbidity. However, there are no recommendations as to how to achieve this. OBJECTIVE: To compare the effectiveness of text-based blood pressure monitoring to in-person visits for women with hypertensive disorders of pregnancy in the immediate postpartum period. METHODS: Randomised clinical trial among 206 postpartum women with pregnancy-related hypertension diagnosed during the delivery admission between August 2016 and January 2017...
April 27, 2018: BMJ Quality & Safety
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