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Guiding Principles for Privileging of Innovative Procedures in Gynecologic Surgery

Number 674

ABSTRACT New or emerging surgical procedures and technologies continue to be developed at a rapid rate and must be implemented safely into clinical practice Additional privileging may be required if substantively new technical or cognitive skills are required to implement an innovative procedure o...

September 2016

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Perinatal Risks Associated With Assisted Reproductive Technology

Number 671

(Replaces Committee Opinion No. 324, November 2005)

ABSTRACT Over the past decades the use of assisted reproductive technology ART has increased dramatically worldwide and has made pregnancy possible for many infertile couples Although the perinatal risks that may be associated with ART and ovulation induction are much higher in multifetal gestatio...

September 2016

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Refusal of Medically Recommended Treatment During Pregnancy

Number 664

(Replaces Committee Opinion Number 321, November 2005)

ABSTRACT One of the most challenging scenarios in obstetric care occurs when a pregnant patient refuses recommended medical treatment that aims to support her wellbeing her fetuss wellbeing or both In such circumstances the obstetriciangynecologists ethical obligation to safeguard the pregnant wom...

June 2016

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Breast and Labial Surgery in Adolescents

Number 662

ABSTRACT The obstetriciangynecologist may receive requests from adolescents and their families for advice surgery or referral for conditions of the breast or vulva to improve appearance and function Appropriate counseling and guidance of adolescents with these concerns require a comprehensive and ...

May 2016

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Clinical Guidelines and Standardization of Practice to Improve Outcomes

Number 629

(Replaces Committee Opinion 526, May 2012)

ABSTRACT Protocols and checklists have been shown to reduce patient harm through improved standardization and communication Implementation of protocols and guidelines often is delayed because of lack of health care provider awareness or difficult clinical algorithms in medical institutions However...

April 2015

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Robotic Surgery in Gynecology

Number 628

ABSTRACT The field of robotic surgery has developed rapidly and its use for gynecologic conditions has grown exponentially Surgeons should be skilled at abdominal and laparoscopic approaches for a specific procedure before undertaking robotic approaches Surgeon training competency guidelines and q...

March 2015

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Cervical Cancer Screening in Low-Resource Settings

Number 624

ABSTRACT Cytologybased cervical cancer screening programs require a number of elements to be successful Certain lowresource settings like the US Affiliated Pacific Islands lack these elements Implementing alternative cervical cancer screening strategies in lowresource settings can provide consiste...

February 2015

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Salpingectomy for Ovarian Cancer Prevention

Number 620

ABSTRACT Ovarian cancer has the highest mortality rate out of all types of gynecologic cancer and is the fifth leading cause of cancer deaths among women Current attempts at screening for ovarian cancer have been unsuccessful and are associated with falsepositive test results that lead to unnecess...

January 2015

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Gynecologic Surgery in the Obese Woman

Number 619

ABSTRACT Obesity is a serious problem worldwide and particularly in the United States and in women is associated with an increased risk of death and morbid conditions including hypertension diabetes mellitus obstructive sleep apnea and hypercholesterolemia as well as malignancies such as endometri...

January 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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Management of Pregnant Women With Presumptive Exposure to Listeria monocytogenes

Number 614

(Reaffirmed 2016)

ABSTRACT Listeriosis is predominantly a foodborne illness with sporadic and outbreakrelated cases tied to consumption of food contaminated with listeria Listeria monocytogenes The incidence of listeriosis associated with pregnancy is approximately 13 times higher than in the general population Mat...

December 2014

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Chronic Antithrombotic Therapy and Gynecologic Surgery

Number 610

ABSTRACT Surgery can present a management dilemma for gynecologists whose patients receive chronic antithrombotic therapy because the risk of hemorrhagic complications must be balanced against the risk of thromboembolic complications Interruption of antithrombotic therapy to reduce perioperative b...

October 2014

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Options for Prevention and Management of Heavy Menstrual Bleeding in Adolescent Patients Undergoing

Number 606

ABSTRACT Adolescents undergoing cancer treatment are at high risk of heavy menstrual bleeding and gynecologists may be consulted either before the initiation of cancer treatment to request strategies for menstrual suppression or during an episode of severe heavy bleeding to stop the bleeding emerg...

August 2014

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Primary Ovarian Insufficiency in Adolescents and Young Women

Number 605

(Reaffirmed 2016)

ABSTRACT Primary ovarian insufficiency is the depletion or dysfunction of ovarian follicles with cessation of menses before age 40 years There is no consensus on criteria to identify primary ovarian insufficiency in adolescents and delay in diagnosis is common Health care providers who make this c...

July 2014

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Elective Surgery and Patient Choice

Number 578

(Replaces No. 395, January 2008)

ABSTRACT Acknowledgment of the importance of patient autonomy and increased patient access to information such as information on the Internet has prompted more patientgenerated requests for surgical interventions not traditionally recommended Depending on the context acceding to a request for a su...

November 2013

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Müllerian Agenesis: Diagnosis, Management, and Treatment

Number 562

(Replaces No. 355, December 2006, Reaffirmed 2015)

ABSTRACT Müllerian agenesis occurs in 1 out of every 400010000 females The most common presentation of müllerian agenesis is congenital absence of the vagina uterus or both which also is referred to as müllerian aplasia MayerRokitanskyKüsterHauser syndrome or vaginal agenesis Satisfactory vaginal ...

May 2013

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Cesarean Delivery on Maternal Request

Number 559

(Reaffirmed 2015)

ABSTRACT Cesarean delivery on maternal request is defined as a primary prelabor cesarean delivery on maternal request in the absence of any maternal or fetal indications Potential risks of cesarean delivery on maternal request include a longer maternal hospital stay an increased risk of respirator...

April 2013

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Management of Acute Abnormal Uterine Bleeding in Nonpregnant Reproductive-Aged Women

Number 557

(Reaffirmed 2015)

ABSTRACT Initial evaluation of the patient with acute abnormal uterine bleeding should include a prompt assessment for signs of hypovolemia and potential hemodynamic instability After initial assessment and stabilization the etiologies of acute abnormal uterine bleeding should be classified using ...

April 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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Reprocessed Single-Use Devices

Number 537

(Reaffirmed 2014)

ABSTRACT The reprocessing and reuse of singleuse instruments has become increasingly common Although there are limited data on reprocessed singleuse devices existing studies have found a significant rate of physical defects performance issues or improper decontamination There are currently no data...

October 2012

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American Congress of Obstetricians and Gynecologists
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