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Tubal Ligation with Cesarean Delivery

Number 205

Tubal ligation at the time of cesarean delivery requires significant additional physician work even though the technical work of the procedure is brief Informed consent by the patient requires considerably more counseling by the physician regarding potential risks and benefits of this procedure th...

August 1998

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Scheduled Cesarean Delivery and the Prevention of Vertical Transmission of HIV Infection

Number 234

(Reaffirmed 2010, Replaces No. 219, August 1999)

Prevention of transmission of the human immunodeficiency virus HIV from mother to fetus or newborn vertical transmission is a major goal in the care of pregnant women infected with HIV An important advance in this regard was the demonstration that treatment of the mother with zidovudine ZDV during...

May 2000

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Statement on Surgical Assistants

Number 240

(Reaffirmed 2013, Replaces No. 145, November 1994)

Competent surgical assistants should be available for all major obstetric and gynecologic operations In many cases the complexity of the surgery or the patients condition will require the assistance of one or more physicians to provide safe quality care Often the complexity of a given surgical pro...

August 2000

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Obstetric Management of Patients with Spinal Cord Injuries

Number 275

(Replaces No. 121, April 1993, Reaffirmed 2014)

ABSTRACT Effective rehabilitation and modern reproductive technology may increase the number of women considering pregnancy who have spinal cord injuries SCIs It is important that obstetricians caring for these patients are aware of the specific problems related to SCIs Autonomic dysreflexia is th...

September 2002

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Pain Relief During Labor

Number 295

(Reaffirmed 2008, Replaces No. 231, February 2000)

ABSTRACT Pain management should be provided whenever medically indicated The American Society of Anesthesiologists ASA and the American College of Obstetricians and Gynecologists ACOG believe that women requesting epidural analgesia during labor should not be deprived of this service based on thei...

July 2004

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Maternal Decision Making Ethics and the Law

Number 321

ABSTRACT Recent legal actions and policies aimed at protecting the fetus as an entity separate from the woman have challenged the rights of pregnant women to make decisions about medical interventions and have criminalized maternal behavior that is believed to be associated with fetal harm or adve...

November 2005

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Analgesia and Cesarean Delivery Rates

Number 339

(Reaffirmed 2013, Replaces No. 269, February 2002)

ABSTRACT Neuraxial analgesia techniques are the most effective and least depressant treatments for labor pain The American College of Obstetricians and Gynecologists previously recommended that practitioners delay initiating epidural analgesia in nulliparous women until the cervical dilatation rea...

June 2006

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Mode of Term Singleton Breech Delivery

Number 340

(Replaces No. 265, December 2001, Reaffirmed 2014)

ABSTRACT In light of recent studies that further clarify the longterm risks of vaginal breech delivery the American College of Obstetricians and Gynecologists recommends that the decision regarding mode of delivery should depend on the experience of the health care provider Cesarean delivery will ...

July 2006

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Amnioinfusion Does Not Prevent Meconium Aspiration Syndrome

Number 346

(Reaffirmed 2014)

ABSTRACT Amnioinfusion has been advocated as a technique to reduce the incidence of meconium aspiration and to improve neonatal outcome However a large proportion of women with meconiumstained amniotic fluid have infants who have taken in meconium within the trachea or bronchioles before meconium ...

October 2006

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Nalbuphine Hydrochloride Use for Intrapartum Analgesia

Number 376

(Reaffirmed 2014)

ABSTRACT Safety concerns have been raised regarding the use of nalbuphine hydrochloride during labor The American College of Obstetricians and Gynecologists finds data are insufficient to recommend any changes in nalbuphine hydrochloride administration at this time Opinion Nalbuphine hydrochloride...

August 2007

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Management of Delivery of a Newborn With Meconium-Stained Amniotic Fluid

Number 379

(Reaffirmed 2013)

ABSTRACT In accordance with the new guidelines from the American Academy of Pediatrics and the American Heart Association all infants with meconiumstained amniotic fluid should no longer routinely receive intrapartum suctioning If meconium is present and the newborn is depressed the clinician shou...

September 2007

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Oral Intake During Labor

Number 441

(Reaffirmed 2013)

ABSTRACT There is insufficient evidence to address the safety of any particular fasting period for solids in obstetric patients Expert opinion supports that patients undergoing either elective cesarean delivery or elective postpartum tubal ligation should undergo a fasting period of 68 hours Adher...

September 2009

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Magnesium Sulfate Before Anticipated Preterm Birth for Neuroprotection

Number 455

Reaffirmed 2015

Abstract Numerous large clinical studies have evaluated the evidence regarding magnesium sulfate neuroprotection and preterm births The Committee on Obstetric Practice and the Society for MaternalFetal Medicine recognize that none of the individual studies found a benefit with regard to their prim...

March 2010

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The Obstetric-Gynecologic Hospitalist

Number 459

(Reaffirmed 2012)

ABSTRACT The work models for the obstetricgynecologic hospitalist and the obstetric laborist are gaining popularity and momentum in hospitals across the nation These models could be timely solutions to the challenging demands of the general practice of obstetrics and gynecology The American Colleg...

July 2010

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Planned Home Birth

Number 476

Reaffirmed 2015

ABSTRACT Although the Committee on Obstetric Practice believes that hospitals and birthing centers are the safest setting for birth it respects the right of a woman to make a medically informed decision about delivery Women inquiring about planned home birth should be informed of its risks and ben...

February 2011

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Prevention of Early-Onset Group B Streptococcal Disease in Newborns

Number 485

(Replaces No. 279, December 2002, Reaffirmed 2015)

ABSTRACT In 2010 the Centers for Disease Control and Prevention revised its guidelines for the prevention of perinatal group B streptococcal disease Although universal screening at 3537 weeks of gestation and intrapartum antibiotic prophylaxis continue to be the basis of the prevention strategy th...

April 2011

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Health Care for Pregnant and Postpartum Incarcerated Women and Adolescent Females

Number 511

(Reaffirmed 2013)

ABSTRACT Clinicians who provide care for incarcerated women should be aware of the special health care needs of pregnant incarcerated women and the specific issues related to the use of restraints during pregnancy and the postpartum period The use of restraints on pregnant incarcerated women and a...

November 2011

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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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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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Compounded Bioidentical Menopausal Hormone Therapy

Number 532

(Reaffirmed 2014, Replaces No. 387, November 2007 and No. 322, November 2005)

ABSTRACT Although improvement in longterm health is no longer an indication for menopausal hormone therapy evidence supporting fewer adverse events in younger women combined with its high overall effectiveness has reinforced its usefulness for shortterm treatment of menopausal symptoms Menopausal ...

August 2012

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American Congress of Obstetricians and Gynecologists
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