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Committee opinion obstetrics

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https://www.readbyqxmd.com/read/30045212/acog-committee-opinion-no-746-air-travel-during-pregnancy
#1
(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
#2
(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
#3
(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/30045206/acog-committee-opinion-no-746-summary-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/30045205/acog-committee-opinion-no-745-summary-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/30045204/acog-committee-opinion-no-744-summary-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/29939935/acog-committee-opinion-no-742-summary-postpartum-pain-management
#7
(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
#8
(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/29794676/acog-committee-opinion-no-741-summary-maternal-immunization
#9
(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/29683911/acog-committee-opinion-no-736-optimizing-postpartum-care
#10
(no author information available yet)
The weeks following birth are a critical period for a woman and her infant, setting the stage for long-term health and well-being. To optimize the health of women and infants, postpartum care should become an ongoing process, rather than a single encounter, with services and support tailored to each woman's individual needs. It is recommended that all women have contact with their obstetrician-gynecologists or other obstetric care providers within the first 3 weeks postpartum. This initial assessment should be followed up with ongoing care as needed, concluding with a comprehensive postpartum visit no later than 12 weeks after birth...
May 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29683906/acog-committee-opinion-no-736-summary-optimizing-postpartum-care
#11
(no author information available yet)
The weeks following birth are a critical period for a woman and her infant, setting the stage for long-term health and well-being. To optimize the health of women and infants, postpartum care should become an ongoing process, rather than a single encounter, with services and support tailored to each woman's individual needs. It is recommended that all women have contact with their obstetrician-gynecologists or other obstetric care providers within the first 3 weeks postpartum. This initial assessment should be followed up with ongoing care as needed, concluding with a comprehensive postpartum visit no later than 12 weeks after birth...
May 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29578986/acog-committee-opinion-no-733-employment-considerations-during-pregnancy-and-the-postpartum-period
#12
(no author information available yet)
In the United States, it is common for women, including mothers and pregnant women, to work outside the home. Working during pregnancy is generally safe. For those in high-risk occupations or with medically complicated pregnancies, work accommodations often can allow for continued safe employment. The major employment issues concerning pregnant women include pregnancy-related discrimination, work accommodations that allow continued employment, job-protected leave, and wage replacement while on leave. Workplace discrimination related to being pregnant and pregnancy-related harassment, including discrimination in the hiring process, is prohibited by federal and state law...
April 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29578985/acog-committee-opinion-no-732-influenza-vaccination-during-pregnancy
#13
(no author information available yet)
Influenza vaccination is an essential element of prepregnancy, prenatal, and postpartum care because influenza can result in serious illness, including a higher chance of progressing to pneumonia, when it occurs during the antepartum or postpartum period. In addition to hospitalization, pregnant women with influenza are at increased risk of intensive care unit admission and adverse perinatal and neonatal outcomes. The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices and the American College of Obstetricians and Gynecologists recommend that all adults receive an annual influenza vaccine and that women who are or will be pregnant during influenza season receive an inactivated influenza vaccine as soon as it is available...
April 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29578984/acog-committee-opinion-no-733-summary-employment-considerations-during-pregnancy-and-the-postpartum-period
#14
(no author information available yet)
In the United States, it is common for women, including mothers and pregnant women, to work outside the home. Working during pregnancy is generally safe. For those in high-risk occupations or with medically complicated pregnancies, work accommodations often can allow for continued safe employment. The major employment issues concerning pregnant women include pregnancy-related discrimination, work accommodations that allow continued employment, job-protected leave, and wage replacement while on leave. Workplace discrimination related to being pregnant and pregnancy-related harassment, including discrimination in the hiring process, is prohibited by federal and state law...
April 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29578983/acog-committee-opinion-no-732-summary-influenza-vaccination-during-pregnancy
#15
(no author information available yet)
Influenza vaccination is an essential element of prepregnancy, prenatal, and postpartum care because influenza can result in serious illness, including a higher chance of progressing to pneumonia, when it occurs during the antepartum or postpartum period. In addition to hospitalization, pregnant women with influenza are at increased risk of intensive care unit admission and adverse perinatal and neonatal outcomes. The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices and the American College of Obstetricians and Gynecologists recommend that all adults receive an annual influenza vaccine and that women who are or will be pregnant during influenza season receive an inactivated influenza vaccine as soon as it is available...
April 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29574750/impact-of-delayed-umbilical-cord-clamping-on-public-cord-blood-donations-can-we-help-future-patients-and-benefit-infant-donors
#16
Rodica Ciubotariu, Andromachi Scaradavou, Ilinca Ciubotariu, Michal Tarnawski, Sara Lloyd, Maria Albano, Ludy Dobrila, Pablo Rubinstein, Amos Grunebaum
BACKGROUND: Cord blood (CB) is a widely accepted stem cell source and its clinical utilization depends, to a great extent, on its cell content. Birth-to-clamping (BTC) time of umbilical cord determines placental transfusion to the newborn, and the remaining blood that can be collected and banked. The 2017 Committee Opinion of the American College of Obstetrics and Gynecologists (ACOG) recommends a delay of "at least 30-60 seconds" before clamping the cord for all newborns to ensure adequate iron stores...
June 2018: Transfusion
https://www.readbyqxmd.com/read/29470344/acog-committee-opinion-no-731-group-prenatal-care
#17
(no author information available yet)
Individual prenatal care is intended to prevent poor perinatal outcomes and provide education to women throughout pregnancy, childbirth, and the postpartum period through a series of one-on-one encounters between a woman and her obstetrician or other obstetric care provider. Concerns regarding increasing health care costs, health care provider availability, dissatisfaction with wait times, and the minimal opportunity for education and support associated with the individual care model have given rise to interest in alternative models of prenatal care...
March 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29470340/acog-committee-opinion-no-731-summary-group-prenatal-care
#18
(no author information available yet)
Individual prenatal care is intended to prevent poor perinatal outcomes and provide education to women throughout pregnancy, childbirth, and the postpartum period through a series of one-on-one encounters between a woman and her obstetrician or other obstetric care provider. Concerns regarding increasing health care costs, health care provider availability, dissatisfaction with wait times, and the minimal opportunity for education and support associated with the individual care model have given rise to interest in alternative models of prenatal care...
March 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29370048/acog-committee-opinion-no-730-fatigue-and-patient-safety
#19
(no author information available yet)
Fatigue and sleep deprivation may affect a health care provider's skills and communication style, and also may affect clinical outcomes. The National Sleep Foundation recommends 7-9 hours of sleep per night for an adult. However, there are no current guidelines limiting the volume of deliveries and procedures performed by a single individual or on the length of time he or she may be on call. Medical literature has shown that even a single night of missed sleep measurably affects cognitive performance. When adults do not sleep at least 5 hours per night, language and numeric skills, retention of information, short-term memory, and concentration all decrease on standardized testing...
February 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29370046/acog-committee-opinion-no-730-summary-fatigue-and-patient-safety
#20
(no author information available yet)
Fatigue and sleep deprivation may affect a health care provider's skills and communication style, and also may affect clinical outcomes. The National Sleep Foundation recommends 7-9 hours of sleep per night for an adult. However, there are no current guidelines limiting the volume of deliveries and procedures performed by a single individual or on the length of time he or she may be on call. Medical literature has shown that even a single night of missed sleep measurably affects cognitive performance. When adults do not sleep at least 5 hours per night, language and numeric skills, retention of information, short-term memory, and concentration all decrease on standardized testing...
February 2018: Obstetrics and Gynecology
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