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Hospital-Based Triage of Obstetric Patients

Number 667

ABSTRACT Emergency departments typically have structured triage guidelines for health care providers encountering the diverse cases that may present to their units Such guidelines aid in determining which patients must be evaluated promptly and which may wait safely and aid in determining anticipa...

July 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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Integrating Immunizations Into Practice

Number 661

ABSTRACT Immunization against vaccinepreventable diseases is an essential component of womens primary and preventive health care Despite the importance of vaccination and clear guidance from public health agencies rates of vaccination lag behind national goals Obstetriciangynecologists can play a ...

April 2016

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Family Building Through Gestational Surrogacy

Number 660

(Replaces Committee Opinion No. 397, February 2008)

ABSTRACT Gestational surrogacy is an increasingly common form of family building that can allow individuals or a couple to become parents despite circumstances in which carrying a pregnancy is biologically impossible or medically contraindicated The practice of gestational surrogacy involves a wom...

March 2016

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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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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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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

(Reaffirmed 2016. 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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The Use of Chromosomal Microarray Analysis in Prenatal Diagnosis

Number 581

(Replaces No. 446, November 2009. Reaffirmed 2015)
(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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Definition of Term Pregnancy

Number 579

Reaffirmed 2015

ABSTRACT In the past the period from 3 weeks before until 2 weeks after the estimated date of delivery was considered term with the expectation that neonatal outcomes from deliveries in this interval were uniform and good Increasingly however research has shown that neonatal outcomes especially re...

November 2013

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Oral Health Care During Pregnancy and Through the Lifespan

Number 569

(Reaffirmed 2015)

ABSTRACT Oral health is an important component of general health and should be maintained during pregnancy and through a womans lifespan Maintaining good oral health may have a positive effect on cardiovascular disease diabetes and other disorders In 20072009 35 of US women reported that they did ...

August 2013

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Update on Immunization and Pregnancy Tetanus Diphtheria and Pertussis Vaccination

Number 566

(Replaces No. 521, March 2012, Reaffirmed 2015)

ABSTRACT In the face of dramatic and persistent increases in pertussis disease in the United States the Centers for Disease Control and Preventions Advisory Committee on Immunization Practices has updated its guidelines for the use of the tetanus toxoid reduced diphtheria toxoid and acellular pert...

June 2013

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Ethical Issues in Pandemic Influenza Planning Concerning Pregnant Women

Number 563

ABSTRACT Pregnant women traditionally have been assigned priority in the allocation of prevention and treatment resources during outbreaks of influenza because of their increased risk of morbidity and mortality The Committee on Ethics of the American College of Obstetricians and Gynecologists expl...

May 2013

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