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Limitations of Perineal Lacerations as an Obstetric Quality Measure

Number 647

ABSTRACT Perineal lacerations are a common occurrence with vaginal delivery Although perineal lacerations are tracked easily from coding data there are a variety of problems with using rates of such tears as a quality measure The rate of severe perineal lacerations should not be used as a measure ...

November 2015

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Dual Therapy for Gonococcal Infections

Number 645

ABSTRACT Gonorrhea is the second most commonly reported bacterial sexually transmitted disease in the United States with an estimated 820000 new Neisseria gonorrhoeae infections occurring each year Antimicrobial resistance limits treatment success heightens the risk of complications and may facili...

November 2015

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First-Trimester Risk Assessment for Early-Onset Preeclampsia

Number 638

ABSTRACT Hypertensive disorders with adverse sequelae including preterm birth maternal morbidity and mortality and longterm risk of maternal cardiovascular disease complicate 510 of pregnancies Early identification of pregnant women at risk of developing earlyonset preeclampsia would theoretically...

September 2015

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Marijuana Use During Pregnancy and Lactation

Number 637

ABSTRACT Cannabis sativa marijuana is the illicit drug most commonly used during pregnancy The selfreported prevalence of marijuana use during pregnancy ranges from 2 to 5 in most studies A growing number of states are legalizing marijuana for medicinal or recreational purposes and its use by preg...

July 2015

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Emergent Therapy for Acute-Onset, Severe Hypertension During Pregnancy and the Postpartum Period

Number 623

(Replaces Committee Opinion Number 514, December 2011)

ABSTRACT Acuteonset severe systolic hypertension severe diastolic hypertension or both can occur in pregnant women or women in the postpartum period Introducing standardized evidencebased clinical guidelines for the management of patients with preeclampsia and eclampsia has been demonstrated to re...

February 2015

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Method for Estimating Due Date

Number 611

(See also Committee Opinion No. 579)

ABSTRACT Accurate dating of pregnancy is important to improve outcomes and is a research and public health imperative As soon as data from the last menstrual period the first accurate ultrasound examination or both are obtained the gestational age and the estimated due date should be determined di...

October 2014

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Definition of Term Pregnancy

Number 579

ABSTRACT In the past the period from 3 weeks before until 2 weeks after the estimated date of delivery was considered term with the expectation that neonatal outcomes from deliveries in this interval were uniform and good Increasingly however research has shown that neonatal outcomes especially re...

November 2013

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Magnesium Sulfate Use in Obstetrics

Number 573

ABSTRACT The US Food and Drug Administration advises against the use of magnesium sulfate injections for more than 57 days to stop preterm labor in pregnant women Based on this the drug classification was changed from Category A to Category D and the labeling was changed to include this new warnin...

September 2013

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Hospital Disaster Preparedness for Obstetricians and Facilities Providing Maternity Care

Number 555

ABSTRACT Numerous occurrences in the past decade have brought the issue of disaster preparedness and specifically hospital preparedness to the national forefront Much of the work in this area has focused on large hospital system preparedness for various disaster scenarios Many unique features of t...

March 2013

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Maternal–Fetal Surgery for Myelomeningocele

Number 550

Reaffirmed 2015

ABSTRACT Myelomeningocele the most severe form of spina bifida occurs in approximately 1 in 1500 births in the United States Fetuses in whom myelomeningocele is diagnosed typically are delivered at term and are treated in the early neonatal period A recent randomized controlled trial found that fe...

January 2013

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Weight Gain During Pregnancy

Number 548

Reaffirmed 2015

ABSTRACT The updated guidelines by the Institute of Medicine regarding gestational weight gain provide clinicians with a basis for practice Health care providers who care for pregnant women should determine a womans body mass index at the initial prenatal visit and counsel her regarding the benefi...

January 2013

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Timing of Umbilical Cord Clamping After Birth

Number 543

(Reaffirmed 2014)

ABSTRACT The optimal timing for clamping the umbilical cord after birth has been a subject of controversy and debate Although many randomized controlled trials in term and preterm infants have evaluated the benefits of delayed umbilical cord clamping versus immediate umbilical cord clamping the id...

December 2012

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Lead Screening During Pregnancy and Lactation

Number 533

(Reaffirmed 2014)

Abstract Prenatal lead exposure has known adverse effects on maternal health and infant outcomes across a wide range of maternal blood lead levels Adverse effects of lead exposure are being identified at lower levels of exposure than previously recognized in both children and adults In 2010 the Ce...

August 2012

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Access to Postpartum Sterilization

Number 530

(Reaffirmed 2014)

ABSTRACT Postpartum tubal sterilization is one of the safest and most effective methods of contraception Women who desire this type of sterilization typically undergo thorough counseling and informed consent during prenatal care and reiterate their desire for postpartum sterilization at the time o...

July 2012

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Placenta Accreta

Number 529

Reaffirmed 2014

ABSTRACT Placenta accreta is a potentially lifethreatening obstetric condition that requires a multidisciplinary approach to management The incidence of placenta accreta has increased and seems to parallel the increasing cesarean delivery rate Women at greatest risk of placenta accreta are those w...

July 2012

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Opioid Abuse, Dependence, and Addiction in Pregnancy

Number 524

(Reaffirmed 2014)

ABSTRACT Opioid use in pregnancy is not uncommon and the use of illicit opioids during pregnancy is associated with an increased risk of adverse outcomes The current standard of care for pregnant women with opioid dependence is referral for opioidassisted therapy with methadone but emerging eviden...

May 2012

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Maternal-Fetal Intervention and Fetal Care Centers

Number 501

(Reaffirmed 2014)

ABSTRACT The past two decades have yielded profound advances in the fields of prenatal diagnosis and fetal intervention Although fetal interventions are driven by a beneficencebased motivation to improve fetal and neonatal outcomes advancement in fetal therapies raises ethical issues surrounding m...

August 2011

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Sulfonamides, Nitrofurantoin, and Risk of Birth Defects

Number 494

(Reaffirmed 2015)

Abstract The evidence regarding an association between the nitrofuran and sulfonamide classes of antibiotics and birth defects is mixed As with all patients antibiotics should be prescribed for pregnant women only for appropriate indications and for the shortest effective duration During the secon...

June 2011

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Nonobstetric Surgery During Pregnancy

Number 474

(Replaces No. 284, August 2003, Reaffirmed 2015)

ABSTRACT The American College of Obstetricians and Gynecologists Committee on Obstetric Practice acknowledges that the issue of nonobstetric surgery during pregnancy is an important concern for physicians who care for women It is important for a physician to obtain an obstetric consultation before...

February 2011

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Smoking Cessation During Pregnancy

Number 471

(Replaces No. 316, October 2005. Reaffirmed 2015)

ABSTRACT Smoking is the one of the most important modifiable causes of poor pregnancy outcomes in the United States and is associated with maternal fetal and infant morbidity and mortality The physical and psychologic addiction to cigarettes is powerful however the compassionate intervention of th...

November 2010

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American Congress of Obstetricians and Gynecologists
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