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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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The Apgar Score

Number 644

(Replaces Committee Opinion Number 333, May 2006)

ABSTRACT The Apgar score provides an accepted and convenient method for reporting the status of the newborn infant immediately after birth and the response to resuscitation if needed The Apgar score alone cannot be considered to be evidence of or a consequence of asphyxia does not predict individu...

October 2015

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Identification and Referral of Maternal Genetic Conditions in Pregnancy

Number 643

ABSTRACT Advances in the understanding of genetic conditions reproductive technologies and improved medical and surgical care have enabled an increasing number of women with genetic conditions to achieve a normal pregnancy outcome However management of certain genetic conditions during pregnancy i...

October 2015

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Cell-free DNA Screening for Fetal Aneuploidy

Number 640

(This Committee Opinion Replaces Committee Opinion Number 545)

ABSTRACT Noninvasive prenatal screening that uses cellfree DNA from the plasma of pregnant women offers tremendous potential as a screening method for fetal aneuploidy A number of laboratories have validated different techniques for the use of cellfree DNA as a screening test for fetal aneuploidy ...

September 2015

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The Importance of Vital Records and Statistics for the Obstetrician-Gynecologist

Number 639

ABSTRACT Information from vital records is critical to identify and quantify healthrelated issues and to measure progress toward quality improvement and public health goals In particular maternal and infant mortality serve as important indicators of the nations health thereby influencing policy de...

September 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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Management of Women With Phenylketonuria

Number 636

(Replaces Committee Opinion Number 449, December 2009)

ABSTRACT Phenylketonuria PKU is an autosomal recessive disorder of phenylalanine Phe metabolism characterized by deficient activity of the hepatic enzyme phenylalanine hydroxylase Increased blood Phe levels are toxic to a variety of tissues particularly the developing fetal brain The mainstay of t...

June 2015

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Prenatal and Perinatal Human Immunodeficiency Virus Testing - Expanded Recommendations

Number 635

(Replaces Committee Opinion Number 418, September 2008)

ABSTRACT Given the enormous advances in the prevention of perinatal transmission of human immunodeficiency virus HIV it is clear that early identification and treatment of all pregnant women with HIV is the best way to prevent neonatal infection and also improve womens health Furthermore new evide...

June 2015

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Screening for Perinatal Depression

Number 630

(Replaces Committee Opinion Number 453, February 2010)

ABSTRACT Perinatal depression which includes major and minor depressive episodes that occur during pregnancy or in the first 12 months after delivery is one of the most common medical complications during pregnancy and the postpartum period affecting one in seven women It is important to identify ...

May 2015

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Health Care for Unauthorized Immigrants

Number 627

(Replaces Committee Opinion Number 425, January 2009)

ABSTRACT Unauthorized undocumented immigrants are less likely than other residents of the United States to have health insurance The American College of Obstetricians and Gynecologists has long supported a basic health care package for all women living within the United States without regard to th...

March 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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Ovarian Reserve Testing

Number 618

ABSTRACT The main goal of ovarian reserve testing is to identify those individuals who are at risk of decreased or diminished ovarian reserve commonly known as DOR Although ovarian reserve testing cannot predict the end of ones reproductive years results outside the range expected for a patients a...

January 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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Influenza Vaccination During Pregnancy

Number 608

(Replaces Committee Opinion Number 468, October 2010)

ABSTRACT The Centers for Disease Control and Preventions Advisory Committee on Immunization Practices and the American College of Obstetricians and Gynecologists recommend that all adults receive an annual influenza vaccine Influenza vaccination is an essential element of preconception prenatal an...

September 2014

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Labor Induction or Augmentation and Autism

Number 597

Abstract Functional oxytocin deficiency and a faulty oxytocin signaling pathway have been observed in conjunction with autism spectrum disorder ASD Because exogenous synthetic oxytocin commonly is administered for labor induction and augmentation some have hypothesized that synthetic oxytocin used...

May 2014

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Immersion in Water During Labor and Delivery

Number 594

ABSTRACT Immersion in water has been suggested as a beneficial alternative for labor or delivery or both and over the past decades has gained popularity in many parts of world Immersion in water during the first stage of labor may be associated with decreased pain or use of anesthesia and decrease...

April 2014

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Preparing for Clinical Emergencies in Obstetrics and Gynecology

Number 590

(Replaces Committee Opinion Number 487, April 2011)

ABSTRACT Patient care emergencies may occur at any time in any setting particularly the inpatient setting It is important that obstetriciangynecologists prepare themselves by assessing potential emergencies establishing early warning systems designating specialized first responders conducting emer...

March 2014

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The Use of Chromosomal Microarray Analysis in Prenatal Diagnosis

Number 581

(Replaces No. 446, November 2009) (See also Practice Bulletin No. 88)

ABSTRACT Chromosomal microarray analysis is a technique that identifies chromosomal abnormalities including submicroscopic abnormalities that are too small to be detected by conventional karyotyping Like conventional fetal karyotyping prenatal chromosomal microarray analysis requires direct testin...

December 2013

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