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1.

Access to Postpartum Sterilization

Number 530, July 2012

(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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2.

Analgesia and Cesarean Delivery Rates

Number 339, June 2006

(Reaffirmed 2016, 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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3.

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

Number 278, November 2002

(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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4.

Breast and Labial Surgery in Adolescents

Number 662, May 2016

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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5.

Cervical Cancer Screening in Low-Resource Settings

Number 624, February 2015

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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6.

Cesarean Delivery on Maternal Request

Number 559, April 2013

(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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7.

Choosing the Route of Hysterectomy for Benign Disease

Number 444, November 2009

(Reaffirmed 2011)

Abstract Hysterectomies are performed vaginally abdominally or with laparoscopic or robotic assistance When choosing the route and method of hysterectomy the physician should take into consideration how the procedure may be performed most safely and costeffectively to fulfill the medical needs of ...

November 2009

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8.

Chronic Antithrombotic Therapy and Gynecologic Surgery

Number 610, October 2014

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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9.

Clinical Guidelines and Standardization of Practice to Improve Outcomes

Number 629, April 2015

(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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10.

Elective Coincidental Appendectomy

Number 323, November 2005

(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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11.

Elective Surgery and Patient Choice

Number 578, November 2013

(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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12.

Ethical Considerations for Performing Gynecologic Surgery in Low-Resource Settings Abroad

Number 466, September 2010

(Reaffirmed 2013)

ABSTRACT International humanitarian medical efforts provide essential services to patients who would not otherwise have access to specific health care services The Committees on Ethics and Global Womens Health of the American College of Obstetricians and Gynecologists encourage College Fellows and...

September 2010

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13.

Guiding Principles for Privileging of Innovative Procedures in Gynecologic Surgery

Number 674, September 2016

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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14.

Gynecologic Surgery in the Obese Woman

Number 619, January 2015

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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15.

Health Care for Transgender Individuals

Number 512, December 2011

ABSTRACT Transgender individuals face harassment discrimination and rejection within our society Lack of awareness knowledge and sensitivity in health care communities eventually leads to inadequate access to underutilization of and disparities within the health care system for this population Alt...

December 2011

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16.

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

Number 557, April 2013

(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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17.

Management of Pregnant Women With Presumptive Exposure to Listeria monocytogenes

Number 614, December 2014

(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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18.

Maternal–Fetal Surgery for Myelomeningocele

Number 550, January 2013

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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19.

Mode of Term Singleton Breech Delivery

Number 340, July 2006

(Replaces No. 265, December 2001, Reaffirmed 2016)

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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20.

Müllerian Agenesis: Diagnosis, Management, and Treatment

Number 562, May 2013

(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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