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Title Date

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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Coding Responsibility

Number 249

(Reaffirmed 2005)

Physicians are responsible for accurately coding the services they provide to their patients Likewise insurers are obligated to process all legitimate insurance claims for covered services accurately and in a timely manner It is inappropriate for physicians to code or for insurers to process claim...

January 2001

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Inappropriate Reimbursement Practices by Third-Party Payers

Number 250

The American College of Obstetricians and Gynecologists ACOG Committee on Coding and Nomenclature believes that physicians must code accurately the services they provide and the diagnoses that justify those services for purposes of appropriate payment This requirement is consistent with the rules ...

January 2001

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Nongynecologic Procedures

Number 253

(Replaces Statement of Policy on Liposuction, January 1988, Reaffirmed 2015)

Cosmetic procedures such as laser hair removal body piercing tattoo removal and liposuction are not considered gynecologic procedures and therefore generally are not taught in approved obstetric and gynecologic residencies Because these are not considered gynecologic procedures it is inappropriate...

March 2001

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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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Avoiding Inappropriate Clinical Decisions Based on False-Positive Human Chorionic Gonadotropin Test Results

Number 278

(Reaffirmed 2015)

ABSTRACT Clinically significant falsepositive human chorionic gonadotropin hCG test results are rare However some individuals have circulating factors in their serum eg heterophilic antibodies or nonactive forms of hCG that interact with the hCG antibody and cause unusual or unexpected test result...

November 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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Nonmedical use of Obstetric Ultrasonography

Number 297

(Reaffirmed 2015)

ABSTRACT The American College of Obstetricians and Gynecologists ACOG has endorsed the Prudent Use statement from the American Institute of Ultrasound in Medicine AIUM discouraging the use of obstetric ultrasonography for nonmedical purposes eg solely to create keepsake photographs or videos The A...

August 2004

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Guidelines for Diagnostic Imaging During Pregnancy

Number 299

(Replaces No. 158, September 1995, Reaffirmed 2014 )

ABSTRACT Undergoing a single diagnostic Xray procedure does not result in radiation exposure adequate to threaten the wellbeing of the developing preembryo embryo or fetus and is not an indication for therapeutic abortion When multiple diagnostic Xrays are anticipated during pregnancy imaging proc...

September 2004

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The Importance of Preconception Care in the Continuum of Women's Health Care

Number 313

(Reaffirmed 2015)

ABSTRACT The goal of preconception care is to reduce the risk of adverse health effects for the woman fetus or neonate by optimizing the womans health and knowledge before planning and conceiving a pregnancy Because reproductive capacity spans almost four decades for most women optimizing womens h...

September 2005

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Screening for Tay - Sachs Disease

Number 318

(Reaffirmed 2014, Replaces No. 162, November 1995)

ABSTRACT TaySachs disease TSD is a severe progressive neurologic disease that causes death in early childhood Carrier screening should be offered before pregnancy to individuals and couples at high risk including those of Ashkenazi Jewish FrenchCanadian or Cajun descent and those with a family his...

October 2005

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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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Elective Coincidental Appendectomy

Number 323

(Reaffirmed 2014, Replaces No. 164, December 1995)

ABSTRACT Because of a lack of evidence from randomized trials it remains unclear whether the benefits of routine elective coincidental appendectomy outweigh the cost and risk of morbidity associated with this prophylactic procedure Because the riskbenefit analysis varies according to patient age a...

November 2005

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Perinatal Risks Associated With Assisted Reproductive Technology

Number 324

(Reaffirmed 2007)

ABSTRACT Over the past two decades the use of assisted reproductive technology ART has increased dramatically worldwide and has made pregnancy possible for many infertile couples A growing body of evidence suggests an association between pregnancies resulting from ART and perinatal morbidity possi...

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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Number 345

(Reaffirmed 2015)

ABSTRACT Vulvodynia is a complex disorder that can be difficult to treat It is described by most patients as burning stinging irritation or rawness Many treatment options have been used including vulvar care measures medication biofeedback training physical therapy dietary modifications sexual cou...

October 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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American Congress of Obstetricians and Gynecologists
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