http://www.acog.org Latest Publications from The American College of Obstetricians and Gynecologists en-us 720 http://blogs.law.harvard.edu/tech/rss Copyright 2009, The American College of Obstetricians and Gynecologists Obstetrics & Gynecolgy Fri, 20 Nov 2009 16:30:00 EST Periodic assessments offer an excellent opportunity for obstetricians and gynecologists to provide preventive screening, evaluation, and counseling. The American College of Obstetricians and Gynecologists' Committee on Gynecologic Practice recommends routine assessments in primary and preventive care for women based on age and risk factors. Fri, 20 Nov 2009 16:30:00 EST http://www.acog.org/publications/committee_opinions/co452.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion Approximately 3 million women in the United States have inherited bleeding disorders. The prevalence of bleeding disorders is particularly high among women with menorrhagia. Von Willebrand disease is the most common inherited bleeding disorder. Once a diagnosis is made, collaboration with a hematologist is helpful for long-term management. Women with von Willebrand disease may be at increased risk for gynecologic and obstetric complications. Many treatments are available for the control of menorrhagia in women with von Willebrand disease, but the first-line therapy remains combined hormonal contraception. Fri, 20 Nov 2009 16:30:00 EST http://www.acog.org/publications/committee_opinions/co451.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion High unintended pregnancy rates in the United States may in part be the result of relatively low use of long-acting reversible contraceptive (LARC) methods, specifically the contraceptive implant and intrauterine devices. Top-tier reversible methods share the characteristic of requiring a single act of motivation for long-term use, eliminating adherence and user-dependence from the effectiveness equation. According to the World Health Organization's evidence-based Medical Eligibility Criteria for contraceptive use, LARC methods have few contraindications, and almost all women are eligible for implants and intrauterine devices. Because of these advantages and the potential to reduce unintended pregnancy rates, LARC methods should be offered as first-line contraceptive methods and encouraged as options for most women. To increase use of LARC methods, barriers such as lack of health care provider knowledge or skills, low patient awareness, and high upfront costs must be addressed. Fri, 20 Nov 2009 16:30:00 EST http://www.acog.org/publications/committee_opinions/co450.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion Phenylketonuria (PKU) is an autosomal recessive disorder of phenylalanine (Phe) metabolism characterized by a deficiency of the hepatic enzyme, phenylalanine hydroxylase, an enzyme responsible for the conversion of phenylalanine to tyrosine, and elevated levels of Phe and Phe metabolite. All women with PKU or hyperphenylalaninemia should be strongly encouraged to receive family planning and preconception counseling. Women with PKU or hyperphenylalaninemia should begin appropriate, medically directed dietary phenylalanine restriction before conception. Fri, 20 Nov 2009 16:30:00 EST http://www.acog.org/publications/committee_opinions/co449.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion Defining the reasons for intervention and the precise goal of treatment are the most critical issues regarding use of interventions to alter menstrual flow in adolescents with disabilities. Reasons for intervention may relate to abnormal uterine bleeding, hygiene, mood issues, fear of pregnancy, and acute onset of other medical conditions. Goals of treatment may include a decrease in the amount of bleeding, periodic amenorrhea, or treatment of symptoms, such as mood issues or dysmenorrhea. First-line treatment options should be safe, minimally invasive, and nonpermanent. Endometrial ablation has not been studied in adolescents, has not been studied long-term, is considered irreversible and, therefore, is not recommended in teenagers. Fri, 20 Nov 2009 16:30:00 EST http://www.acog.org/publications/committee_opinions/co448.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion Since publication of the Institute of Medicine's landmark report To Err is Human: Building a Safer Health System, emphasis on patient safety has steadily increased. Obstetrician-gynecologists should continuously incorporate elements of patient safety into their practices and also encourage others to use these practices. Fri, 20 Nov 2009 16:30:00 EST http://www.acog.org/publications/committee_opinions/co447.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion The incidence of cervical cancer has decreased more than 50% in the past 30 years because of widespread screening with cervical cytology. In 1975, the rate was 14.8 per 100,000 women in the United States; by 2006, it had been reduced to 6.5 per 100,000 women. Mortality from the disease has undergone a similar decrease (1). The American Cancer Society estimates 11,270 new cases of cervical cancer in the United States in 2009, with 4,070 deaths from the disease (2). Recent estimates worldwide, however, are of almost 500,000 new cases and 240,000 deaths from the disease per year (3). When cervical cytology screening programs have been introduced into communities, marked reductions in cervical cancer incidence have followed (4-6). Fri, 20 Nov 2009 08:45:00 EST http://www.acog.org/publications/educational_bulletins/pb109.cfm resources@acog.org (ACOG Resource Center) ACOG Practice Bulletin Group B streptococcus (GBS) is a type of bacteria that is found in 10-30% of pregnant women. A woman with GBS can pass it to her baby during labor and delivery. Most babies who get GBS from their mothers do not have any problems. A few, however, will become sick. This illness can cause serious health problems and it can even be life-threatening. This pamphlet explains: how GBS may affect a newborn; testing for GBS; treatment of GBS, and; treatment in special situations. Tue, 03 Nov 2009 15:10:00 EST http://www.acog.org/publications/patient_education/bp105.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Immunization is coming to the forefront for obstetric-gynecologic practices. Therefore, the American College of Obstetricians and Gynecologists (ACOG) and the ACOG Working Group on Immunization recognized a need for a coding guide solely focused on immunization. Correct coding enables a physician's office immunization program to be profitable and to satisfy payer scrutiny. Codes condense a large amount of information into a short code description. Tue, 03 Nov 2009 10:35:00 EST http://www.acog.org/departments/healthIssues/immunizationCoding.pdf resources@acog.org (ACOG Resource Center) ACOG Publication Most pregnancies last about 40 weeks. Babies born between 32 and 37 weeks of pregnancy are considered preterm. Babies born before 32 weeks are called "early preterm." The earlier a baby is born, the less likely he or she is to survive. Those who do survive are at increased risk for lifelong health problems. This pamphlet explains: what to expect if you give birth to an early preterm baby; health problems that affect early preterm babies; treatment options during pregnancy and delivery; making decisions and finding support, and; caring for a preterm baby. Mon, 02 Nov 2009 09:45:00 EST http://www.acog.org/publications/patient_education/bp173.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Los ovarios son dos organos pequenos que se encuentran en ambos lados del utero de la mujer. Un quiste ovarico es un saco o pequena bolsa llena de liquido o de otro tejido que se forma en el ovario. La presencia de un pequeno quiste en los ovarios es normal. En la mayoria de los casos, los quistes son inofensivos y desaparecen por su cuenta. En otros casos, pueden causar problemas y es necesario tratarlos. Este folleto explica: los tipos de quistes ovaricos; los sintomas, y; el diagnostico y tratamiento. Mon, 26 Oct 2009 16:55:00 EDT http://www.acog.org/publications/patient_education/sp075.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet The widespread use of array comparative genomic hybridization (CGH) for the diagnosis of genomic rearrangements in children with idiopathic mental retardation, developmental delay, and multiple congenital anomalies has spurred interest in applying array CGH technology to prenatal diagnosis. The use of array CGH technology in prenatal diagnosis is currently limited by several factors, including the inability to detect balanced chromosomal rearrangements, the detection of copy number variations of uncertain clinical significance, and significantly higher costs than conventional karyotype analysis. Although array CGH has distinct advantages over classic cytogenetics in certain applications, the technology is not currently a replacement for classic cytogenetics in prenatal diagnosis. Wed, 21 Oct 2009 16:30:00 EDT http://www.acog.org/publications/committee_opinions/co446.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion The utility of antibiotics to prolong pregnancy and reduce neonatal morbidities in women with preterm labor and intact membranes has been evaluated in numerous randomized clinical trials. Antibiotic use intended only for pregnancy prolongation in women with preterm labor with intact membranes does not have short-term neonatal benefits and may be associated with long-term harm. Thus, antibiotics should not be used for this indication in women with preterm labor and intact membranes. Wed, 21 Oct 2009 16:30:00 EDT http://www.acog.org/publications/committee_opinions/co445.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion 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 cost-effectively to fulfill the medical needs of the patient. Evidence demonstrates that, in general, vaginal hysterectomy is associated with better outcomes and fewer complications than laparoscopic or abdominal hysterectomy. When it is not feasible to perform a vaginal hysterectomy, the surgeon must choose between laparoscopic hysterectomy, robot-assisted hysterectomy, or abdominal hysterectomy. Experience with robot-assisted hysterectomy is limited at this time; more data are necessary to determine its role in the performance of hysterectomy. The decision to electively perform a salpingoophorectomy should not be influenced by the chosen route of hysterectomy and is not a contraindication to performing a vaginal hysterectomy. Wed, 21 Oct 2009 16:30:00 EDT http://www.acog.org/publications/committee_opinions/co444.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion The field of robotic surgery is developing rapidly, but experience with this technology is currently limited. In response to increasing interest in robotics technology, the Committee on Gynecologic Practice's Technology Assessment was developed to describe the robotic surgical system, potential advantages and disadvantages, gynecologic applications, and the current state of the evidence. Randomized trials comparing robot-assisted surgery with traditional laparoscopic, vaginal, or abdominal surgery are needed to evaluate long-term clinical outcomes and cost-effectiveness, as well as to identify the best applications of this technology. Wed, 21 Oct 2009 16:15:00 EDT http://www.acog.org/publications/technology_assessment/ta006.cfm resources@acog.org (ACOG Resource Center) ACOG Technology Assessment This newsletter, published 6 times per year, offers synopses of the latest developments in obstetrics, gynecology, oncology, and infertility. Provides a review article on a controversial issue, an historical perspectives, and the yearly review of the ABOG Annual Board Certification examination. Wed, 21 Oct 2009 16:15:00 EDT http://www.acog.org/publications/clinical_review/clinicalReviewv14i6.pdf resources@acog.org (ACOG Resource Center) ACOG Clinical Review If you are like most women, when it comes to your health, cancer ranks high on your list of concerns. But few women have a true sense of their risk of developing cancer or the steps they can take to reduce that risk. For instance, while most of us are aware that more women in the US are diagnosed with breast cancer than any other kind of cancer each year, few are aware that more women die of lung cancer than breast, uterine, and ovarian cancers combined. Tue, 29 Sep 2009 15:45:00 EDT http://www.acog.org/from_home/misc/protectanddetectsplash.cfm communications@acog.org (ACOG Office of Communications) ACOG Publication The ovaries are two small organs located on either side of a woman's uterus. An ovarian cyst is a sac or pouch filled with fluid or other tissue that forms on the ovary. It is normal for a small cyst to develop on the ovaries. In most cases, cysts are harmless and go away on their own. In other cases, they may cause problems and need treatment. This pamphlet explains: types of ovarian cysts; symptoms, and; diagnosis and treatment. Thu, 24 Sep 2009 12:30:00 EDT http://www.acog.org/publications/patient_education/bp075.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet La sangre de cordon umbilical es la sangre del bebe que permanece en el cordon umbilical y en la placenta despues del parto. esta contiene celulas que se denominan celulas madre hematopoyeticas (que producen sangre) y que se pueden usar para tratar algunas enfermedades. Es posible, hoy en dia, donar sangre del cordon umbilical a bancos publicos o conservarla en un banco privado para usarla en el futuro. Este folleto explica: la diferencia entre celulas madre y otras celulas; como las celulas madre en la sangre del cordon umbilical se pueden usar para tratar enfermedades; cuando las celulas madre no se pueden usar para tratar enfermedades,y; como la sangre del cordon umbilical se extrae y conserva. Tue, 22 Sep 2009 13:30:00 EDT http://www.acog.org/publications/patient_education/sp172.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Polycystic ovary syndrome (PCOS) is a disorder characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovaries. Its etiology remains unknown, and treatment is largely symptom based and empirical. PCOS has the potential to cause substantial metabolic sequelae, including an increased risk of diabetes and cardiovascular disease, and these factors should be considered when determining long-term treatment. The purpose of this document is to examine the best available evidence for the diagnosis and clinical management of PCOS. Mon, 21 Sep 2009 09:00:00 EDT http://www.acog.org/publications/educational_bulletins/pb108.cfm resources@acog.org (ACOG Resource Center) ACOG Practice Bulletin In the absence of obstetric or medical complications, pregnant women can observe the same precautions for air travel as the general population and can fly safely. Pregnant women should be instructed to continuously use their seat belts while seated, as should all air travelers. Pregnant air travelers may take precautions to ease in-flight discomfort and, although no hard evidence exists, preventive measures can be used to minimize risks of venous thrombosis. For most air travelers, the risks to the fetus from exposure to cosmic radiation are negligible. For pregnant aircrew members and other frequent flyers, this exposure may be higher. Information is available from the FAA to estimate this exposure. Mon, 21 Sep 2009 09:00:00 EDT http://www.acog.org/publications/committee_opinions/co443.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion Certain autosomal recessive disease conditions are more prevalent in individuals of Eastern European Jewish (Ashkenazi) descent. Previously, the American College of Obstetricians and Gynecologists recommended that individuals of Eastern European Jewish ancestry be offered carrier screening for Tay-Sachs disease, Canavan disease, and cystic fibrosis as part of routine obstetric care. Based on the criteria used to justify offering carrier screening for Tay-Sachs disease, Canavan disease, and cystic fibrosis, the American College of Obstetricians and Gynecologists' Committee on Genetics recommends that couples of Ashkenazi Jewish ancestry also should be offered carrier screening for familial dysautonomia. Individuals of Ashkenazi Jewish descent may inquire about the availability of carrier screening for other disorders. Carrier screening is available for mucolipidosis IV, Niemann-Pick disease type A, Fanconi anemia group C, Bloom syndrome, and Gaucher disease. Mon, 21 Sep 2009 09:00:00 EDT http://www.acog.org/publications/committee_opinions/co442.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion This newsletter, published 6 times per year, offers synopses of the latest developments in obstetrics, gynecology, oncology, and infertility. Provides a review article on a controversial issue, an historical perspectives, and the yearly review of the ABOG Annual Board Certification examination. Mon, 21 Sep 2009 09:00:00 EDT http://www.acog.org/publications/clinical_review/clinicalReviewv14i5.pdf resources@acog.org (ACOG Resource Center) ACOG Clinical Review El dolor de espalda es una de las molestias mas comunes del embarazo. A medida que crece el bebe, el utero se expande hasta 1,000 veces mas del tamano original. Esta cantidad de crecimiento--cuando esta centrada en un area--afecta el equilibrio del cuerpo y puede causar molestias. Este folleto explicalas: causas del dolor de espalda durante el embarazo; consejos para aliviar el dolor de espalda, y; cuando necesita acudir a su proveedor de atencion medica. Thu, 17 Sep 2009 11:35:00 EDT http://www.acog.org/publications/patient_education/sp115.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Monthly newsletter for ACOG members. Tue, 08 Sep 2009 10:25:00 EDT http://www.acog.org/publications/acog_newsletters/acogToday0909.pdf resources@acog.org (ACOG Resource Center) ACOG Today Newsletter El cuello uterino de la mujer (la abertura del utero) esta recubierto por celulas. El cancer del cuello uterino ocurre cuando se alteran esas celulas, lo cual puede afectar las capas mas profundas de celulas o diseminarse a otros organos y causar dano. Si el cancer se detecta y trata en sus primeras etapas, es posible curar hasta un 90% de las mujeres que lo padecen. Cuanto mas haya avanzado la enfermedad, mas baja sera la tasa de curacion. Por ese motivo es mejor detectarla cuando se empieza a desarrollar. Este folleto explicara: Quienes corren riesgo de presentar cancer del cuello uterino; Los sintomas de la enfermedad, y; Los tratamientos. Wed, 02 Sep 2009 16:10:00 EDT http://www.acog.org/publications/patient_education/sp163.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Infectious Diseases in Obstetrics and Gynecology was developed by experts in the field to provide current information on infectious diseases and their effects on the female genitalia. This self-assessment tool examines the pathology, etiology, risk factors, diagnosis, and management of these diseases. Tue, 01 Sep 2009 12:45:00 EDT http://www.acog.org/publications/infectiousDiseases resources@acog.org (ACOG Resource Center) ACOG Publication Cord blood is the blood from the baby that is left in the umbilical cord and placenta after birth. It contains cells called hematopoietic (blood-forming) stem cells that can be used to treat some diseases. It is now possible to donate cord blood to a public bank or store it in a private bank for future use. This pamphlet explains: the difference between stem cells and other cells; how the stem cells in cord blood can be used to treat disease; when stem cells cannot be used to treat disease, and; how cord blood is collected and stored. Fri, 28 Aug 2009 08:55:00 EDT http://www.acog.org/publications/patient_education/bp172.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Objective: To address the maternal and neonatal risks of both depression and antidepressant exposure and develop algorithms for periconceptional and antenatal management. Method: Representatives from the American Psychiatric Association, the American College of Obstetricians and Gynecologists and a consulting developmental pediatrician collaborated to review English language articles on fetal and neonatal outcomes associated with depression and antidepressant treatment during childbearing. Articles were obtained from Medline searches and bibliographies. Search keywords included pregnancy, pregnancy complications, pregnancy outcomes, depressive disorder, depressive disorder/dt, abnormalities/drug-induced/epidemiology, abnormalities/drug-induced/et. Iterative draft manuscripts were reviewed until consensus was achieved. Results: Both depressive symptoms and antidepressant exposure are associated with fetal growth changes and shorter gestations, but the majority of studies that evaluated antidepressant risks were unable to control for the possible effects of a depressive disorder. Short-term neonatal irritability and neurobehavioral changes are also linked with maternal depression and antidepressant treatment. Several studies report fetal malformations in association with first trimester antidepressant exposure but there is no specific pattern of defects for individual medications or class of agents. The association between paroxetine and cardiac defects is more often found in studies that included all malformations rather than clinically significant malformations. Late gestational use of selective serotonin reuptake inhibitor antidepressants is associated with transitory neonatal signs and a low risk for persistent pulmonary hypertension in the newborn. Psychotherapy alone is an appropriate treatment for some pregnant women; however, others prefer pharmacotherapy or may require pharmacological treatment. Conclusions: Antidepressant use in pregnancy is well studied, but available research has not yet adequately controlled for other factors that may influence birth outcomes including maternal illness or problematic health behaviors that can adversely affect pregnancy. Tue, 25 Aug 2009 15:30:00 EDT http://www.acog.org/publications/taskForceReports/ManagementOfDepressionDuringPregnancy.pdf resources@acog.org (ACOG Resource Center) ACOG Task Force/Work Group Report There is insufficient evidence to address the safety of any particular fasting period for solids in obstetric patients. Expert opinion supports that patients undergoing either elective cesarean delivery or elective postpartum tubal ligation should undergo a fasting period of 6-8 hours. Adherence to a predetermined fasting period before nonelective surgical procedures (ie, cesarean delivery) is not possible. Therefore, solid foods should be avoided in laboring patients. Fri, 21 Aug 2009 08:25:00 EDT http://www.acog.org/publications/committee_opinions/co441.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion Tener un bebe y cuidar de un recien nacido es una labor ardua. Restablecer la fortaleza despues del esfuerzo que implica el embarazo y el parto lleva algo de tiempo. Debe permitirle al cuerpo tener un tiempo para recuperarse. Sin embargo, en cuanto se sienta lista, hable con su medico para saber cuando puede comenzar un programa de ejercicios. Este folleto explica: los beneficios del ejercicio; ejercicios que son adecuados para comenzar a ejercitarse, y;los programas que la mantendran en forma. Thu, 20 Aug 2009 16:30:00 EDT http://www.acog.org/publications/patient_education/sp131.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Los defectos congenitos afectan aproximadamente a 1 de cada 33 bebes que nacen en Estados Unidos cada ano. Aunque no es posible prevenir algunos defectos congenitos, para otros se pueden tomar medidas a fin de reducir el riesgo de tener un nino con un defecto congenito. Se dispone tambien de pruebas prenatales para determinar o detectar algunos defectos congenitos. Este folleto explica: los tipos de defectos congenitos; las causas mas comunes; las medidas que puede tomar para reducir su riesgo, y; las opciones de deteccion y diagnostico para defectos congenitos. Wed, 19 Aug 2009 13:05:00 EDT http://www.acog.org/publications/patient_education/sp146.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet La diabetes mellitus ("diabetes") es una enfermedad que causa que se eleven los niveles de glucosa en la sangre. La glucosa es el azucar que provee la fuente principal de energia del organismo. Cuando los niveles de glucosa son demasiado elevados pueden presentarse problemas de salud. La diabetes mellitus pregestacional es la diabetes que ocurre antes del embarazo. Cuando la diabetes comienza durante el embarazo, se denomina diabetes mellitus gestacional. Ambos tipos de diabetes requieren atencion especial durante el embarazo. Este folleto explica: la diabetes pregestacional y gestacional; los efectos de la diabetes en el embarazo; como regular la diabetes durante el embarazo, y; el parto y la atencion postparto. Tue, 18 Aug 2009 12:10:00 EDT http://www.acog.org/publications/patient_education/sp051.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Back pain is one of the most common discomforts during pregnancy. As your baby grows, your uterus expands to as much as 1,000 times its original size. This amount of growth--when centered in one area--affects the balance of your body and may cause discomfort. This pamphlet explains: the causes of back pain during pregnancy; tips for easing back pain, and; when to see your health care provider. Thu, 13 Aug 2009 18:15:00 EDT http://www.acog.org/publications/patient_education/bp115.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Monthly newsletter for ACOG members. Fri, 31 Jul 2009 10:50:00 EDT http://www.acog.org/publications/acog_newsletters/acogToday0809.pdf resources@acog.org (ACOG Resource Center) ACOG Today Newsletter Birth defects affect about 1 in 33 babies born in the United States each year. Some birth defects cannot be prevented. With others, there are steps you can take to reduce your risk of having a child with a certain defect. Prenatal tests also are available that check for or detect some birth defects. This pamphlet explains: types of birth defects; common causes; things you can do that may reduce your risk, and; screening and diagnostic testing options for birth defects. Thu, 30 Jul 2009 09:55:00 EDT http://www.acog.org/publications/patient_education/bp146.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Si usted es como la mayoria de los padres que esperan un bebe, debe sentirse tanto emocionado como ansioso sobre este importante paso en las vidas de usted y de su pareja. Usted puede ayudar a su pareja entendiendo los cambios por los que esta pasando y siendo un futuro padre bien preparado y dandole todo su apoyo. Este folleto explica: por que es importante el papel del padre para tener un embarazo sano; los cambios fisicos y emocionales que experimentara su pareja durante el embarazo; las relaciones sexuales durante y despues del embarazo; lo que sucede durante las consultas de atencion medica prenatal; como ayudar durante el trabajo de parto y el parto mismo, y; lo que pueden hacer los padres despues de que nace el bebe. Tue, 28 Jul 2009 13:30:00 EDT http://www.acog.org/publications/patient_education/sp032.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Having a baby and taking care of a newborn are hard work. It will take a while to regain your strength after the strain of pregnancy and birth. You should allow your body time to recover. But, as soon as you feel up to it, talk to your doctor about when you can start an exercise program. This pamphlet explains: the benefits of exercise; good exercises to get you started, and; programs to keep you going. Fri, 24 Jul 2009 11:45:00 EDT http://www.acog.org/publications/patient_education/bp131.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Excellence in women's health care is an essential element of the long-term physical, intellectual, social and economic well-being of any society. It is a basic determinant of the health of future generations. Tue, 21 Jul 2009 09:45:00 EDT http://www.acog.org/publications/policy_statements/sop9909.cfm resources@acog.org (ACOG Resource Center) ACOG Statements of Policy The American College of Obstetricians and Gynecologists finds the targeting of women of all ages by the tobacco industry unconscionable and strongly opposes the practice. Tue, 21 Jul 2009 09:45:00 EDT http://www.acog.org/publications/policy_statements/sop9007.cfm resources@acog.org (ACOG Resource Center) ACOG Statements of Policy More than 22% of all gravid women undergo induction of labor in the United States, and the overall rate of induction of labor in the United States has more than doubled since 1990 to 225 per 1,000 live births in 2006 (1). The goal of induction of labor is to achieve vaginal delivery by stimulating uterine contractions before the spontaneous onset of labor. Generally, induction of labor has merit as a therapeutic option when the benefits of expeditious delivery outweigh the risks of continuing the pregnancy. The benefits of labor induction must be weighed against the potential maternal and fetal risks associated with this procedure (2). The purpose of this document is to review current methods for cervical ripening and induction of labor and to summarize the effectiveness of these approaches based on appropriately conducted outcomes-based research. These practice guidelines classify the indications for and contraindications to induction of labor, describe the various agents used for cervical ripening, cite methods used to induce labor, and outline the requirements for the safe clinical use of the various methods of inducing labor. Tue, 21 Jul 2009 09:15:00 EDT http://www.acog.org/publications/educational_bulletins/pb107.cfm resources@acog.org (ACOG Resource Center) ACOG Practice Bulletin The clinical approach to postmenopausal bleeding requires prompt and efficient evaluation to exclude or diagnose carcinoma. Women with postmenopausal bleeding may be assessed initially with either endometrial biopsy or transvaginal ultrasonography; this initial evaluation does not require performance of both tests. Transvaginal ultrasonography can be useful in the triage of patients in whom endometrial sampling was performed but tissue was insufficient for diagnosis. When transvaginal ultrasonography is performed for patients with postmenopausal bleeding and an endometrial thickness of less than or equal to 4 mm is found, endometrial sampling is not required. Meaningful assessment of the endometrium by ultrasonography is not possible in all patients. In such cases, alternative assessment should be completed. When bleeding persists despite negative initial evaluations, additional assessment usually is indicated. Tue, 21 Jul 2009 09:15:00 EDT http://www.acog.org/publications/committee_opinions/co440.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion Obtaining informed consent for medical treatment, for participation in medical research, and for participation in teaching exercises involving students and residents is an ethical requirement that is partially reflected in legal doctrines and requirements. As an ethical doctrine, informed consent is a process of communication whereby a patient is enabled to make an informed and voluntary decision about accepting or declining medical care. In this Committee Opinion, the American College of Obstetricians and Gynecologists' Committee on Ethics describes the history, ethical basis, and purpose of informed consent and identifies special ethical questions pertinent to the practice of obstetrics and gynecology. Two major elements in the ethical concept of informed consent, comprehension (or understanding) and free consent, are reviewed. Limits to informed consent are addressed. Tue, 21 Jul 2009 09:15:00 EDT http://www.acog.org/publications/committee_opinions/co439.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion To provide optimal protection for the pregnant woman and her neonate, preconception immunization is preferred to vaccination during pregnancy. However, when indicated, the benefits of immunization to the pregnant woman and her neonate usually outweigh the theoretic risks of adverse effects. To add protection against pertussis or for pregnant women who need tetanus or diphtheria protection during pregnancy, immunization with the diphtheria and reduced tetanus toxoids and acellular pertussis vaccine (Tdap) instead of the tetanus and diphtheria toxoids (Td) vaccine may be considered in the second or third trimester. Pregnant women (including women who are breastfeeding) who have not received a dose of Tdap previously, should receive it after delivery and before discharge from the hospital if 2 years or more have elapsed since the most recent Td vaccination. Current information on the safety of vaccines given during pregnancy is frequently updated and may be verified from the Centers for Disease Control and Prevention web site at www.cdc.gov/vaccines. Tue, 21 Jul 2009 09:15:00 EDT http://www.acog.org/publications/committee_opinions/co438.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion La seguridad en los automoviles es importante antes y despues del nacimiento de su bebe. Cuando esta embarazada, la mejor manera de protegerse y proteger a su bebe en un automovil es usando los cinturones de seguridad. Una vez que nazca el bebe, asegurese de colocar debidamente al nino en un asiento de seguridad especial. Este folleto explica: la importancia de mantenerse segura en un automovil durante el embarazo; como usar el cinturon de seguridad durante el embarazo; como las bolsas de aire la protegen durante el embarazo; los tipos de asientos de seguridad para bebes y ninos mayores, y; como seleccionar y usar un asiento de seguridad para el automovil. Wed, 08 Jul 2009 12:40:00 EDT http://www.acog.org/publications/patient_education/sp018.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Monthly newsletter for ACOG members. Tue, 30 Jun 2009 15:50:00 EDT http://www.acog.org/publications/acog_newsletters/acogToday0709.pdf resources@acog.org (ACOG Resource Center) ACOG Today Newsletter If you are like most expectant fathers, you are both excited and anxious about this big step in the lives of you and your partner. You can help your partner by understanding the changes she is going through and by being a prepared and supportive father-to-be. This pamphlet explains: why the father's role is important to a healthy pregnancy; the physical and emotional changes your partner will experience during pregnancy; sex during and after pregnancy; what happens during prenatal care visits; how to help during labor and delivery, and; what fathers can do after the baby is born. Fri, 26 Jun 2009 13:45:00 EDT http://www.acog.org/publications/patient_education/bp032.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet In the most recent year for which data are available, approximately 3.4 million fetuses (85% of approximately 4 million live births) in the United States were assessed with electronic fetal monitoring (EFM), making it the most common obstetric procedure (1). Despite its widespread use, there is controversy about the efficacy of EFM, interobserver and intraobserver variability, nomenclature, systems for interpretation, and management algorithms. Moreover, there is evidence that the use of EFM increases the rate of cesarean deliveries and operative vaginal deliveries. The purpose of this document is to review nomenclature for fetal heart rate assessment, review the data on the efficacy of EFM, delineate the strengths and shortcomings of EFM, and describe a system for EFM classification. Mon, 22 Jun 2009 10:15:00 EDT http://www.acog.org/publications/educational_bulletins/pb106.cfm resources@acog.org (ACOG Resource Center) ACOG Practice Bulletin As professional and community leaders, obstetrician-gynecologists have unlimited opportunities to become involved in and have a positive impact on local, national, and international communities and organizations. Volunteering outside of daily work routines often revitalizes a commitment to medicine while serving as a much needed resource to the community. Mon, 22 Jun 2009 10:15:00 EDT http://www.acog.org/publications/committee_opinions/co437.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion This newsletter, published 6 times per year, offers synopses of the latest developments in obstetrics, gynecology, oncology, and infertility. Provides a review article on a controversial issue, an historical perspectives, and the yearly review of the ABOG Annual Board Certification examination. Mon, 22 Jun 2009 10:15:00 EDT http://www.acog.org/publications/clinical_review/clinicalReviewv14i4.pdf resources@acog.org (ACOG Resource Center) ACOG Clinical Review Car safety is important before and after your baby is born. When you are pregnant, the best way to keep yourself and your baby safe in a car is to use safety belts. After your baby is born, make sure your baby is strapped into a special safety seat. This pamphlet explains: the importance of car safety during pregnancy; how to wear a safety belt during pregnancy; how air bags help protect you during pregnancy; types of safety seats for babies and older children, and; how to choose and use a car safety seat. Mon, 08 Jun 2009 09:00:00 EDT http://www.acog.org/publications/patient_education/bp018.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Diabetes mellitus ("diabetes") is a condition that causes high levels of glucose in the blood. Glucose is a sugar that is the body's main source of energy. Health problems can arise when glucose levels are too high. Pregestational diabetes mellitus is diabetes that was present before pregnancy. When diabetes starts during pregnancy, it is called gestational diabetes mellitus. Both types of diabetes need special care during pregnancy. This pamphlet explains: pregestational and gestational diabetes; effects of diabetes on pregnancy; how to control diabetes during pregnancy, and delivery and postpartum care. Wed, 03 Jun 2009 16:35:00 EDT http://www.acog.org/publications/patient_education/bp051.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet La prueba de Papanicolaou detecta cambios en el cuello uterino que pueden convertirse en cancer. Si la prueba de Papanicolaou revela estos cambios, el resultado se considera anormal. En las mujeres que se hacen pruebas regulares de Papanicolaou, casi siempre se detectan a tiempo los cambios anormales. Un resultado anormal en la prueba de Papanicolaou quiere decir que puede ser necesario realizar otros examenes y dar seguimiento. Este folleto explica: lo que detecta la prueba de Papanicolaou; la causa mas comun de los resultados anormales en la prueba de Papanicolaou; los tipos de resultados anormales en la prueba de Papanicolaou, y; los examenes adicionales y posibles tratamientos que podrian hacerse. Tue, 02 Jun 2009 16:25:00 EDT http://www.acog.org/publications/patient_education/sp161.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Si el resultado de su prueba de Papanicolaou es anormal, el medico puede recomendar un procedimiento de asa de excision electroquirurgica (LEEP, por sus siglas en ingles) como parte de la evaluacion o tratamiento. Este procedimiento se usa para extraer el area que contiene las celulas anormales del cuello uterino. Este folleto explica: el significado de un resultado anormal de la prueba de Papanicolaou; como se realiza el procedimiento de LEEP; los riesgos del procedimiento; que puede esperar durante la recuperacion, y; como mantenerse sana. Thu, 21 May 2009 15:35:00 EDT http://www.acog.org/publications/patient_education/sp110.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet La espera antes del nacimiento de un bebe es un periodo emocionante y ansioso. La mayoria de las mujeres dan a luz entre las 38 y 42 semanas de embarazo. Sin embargo, no hay manera de determinar con exactitud cuando comenzara el trabajo de parto. El nacimiento a menudo ocurre dentro de un plazo de 2 semanas antes o despues de la fecha prevista del parto. Este folleto explicara: como planear para el nacimiento de su bebe; las senales de que esta comenzando el trabajo de parto, y; como distinguir entre el trabajo de parto falso y el verdadero. Thu, 21 May 2009 15:35:00 EDT http://www.acog.org/publications/patient_education/sp004.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet As the rate of obesity increases, it is becoming more common for providers of women's health care to encounter patients who are either contemplating or have had operative procedures for weight loss, also known as bariatric surgery. The counseling and management of patients who become pregnant after bariatric surgery can be complex. Although pregnancy outcomes generally have been favorable after bariatric surgery, nutritional and surgical complications can occur and some of these complications can result in adverse perinatal outcomes. The purpose of this Practice Bulletin is to provide a summary of the risks of obesity in pregnancy, review the available literature regarding outcomes of pregnancy after bariatric surgery, and provide recommendations for the care of the patient during her pregnancy and delivery after bariatric surgery. Thu, 21 May 2009 08:30:00 EDT http://www.acog.org/publications/educational_bulletins/pb105.cfm resources@acog.org (ACOG Resource Center) ACOG Practice Bulletin Establishing the diagnosis of gestational diabetes mellitus offers an opportunity not only to improve pregnancy outcome, but also to decrease risk factors associated with the subsequent development of type 2 diabetes. The American College of Obstetricians and Gynecologists' Committee on Obstetric Practice recommends that all women with gestational diabetes mellitus be screened at 6 12 weeks postpartum and managed appropriately. Thu, 21 May 2009 08:30:00 EDT http://www.acog.org/publications/committee_opinions/co435.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion The relationship between induced abortion and the subsequent development of breast cancer has been the subject of a substantial amount of epidemiologic study. Early studies of the relationship between prior induced abortion and breast cancer risk were methodologically flawed. More rigorous recent studies demonstrate no causal relationship between induced abortion and a subsequent increase in breast cancer risk. Thu, 21 May 2009 08:30:00 EDT http://www.acog.org/publications/committee_opinions/co434.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion The Pap test checks for changes in the cervix that may become cancer. If a Pap test shows these changes, the result is called abnormal. In women who have regular Pap tests, abnormal changes are almost always caught early. An abnormal Pap test result may mean that further testing and follow-up are needed. This pamphlet explains: what a Pap test checks for; the most common cause of abnormal Pap test results; types of abnormal Pap test results, and; further tests and possible treatments that might be done. Wed, 13 May 2009 17:00:00 EDT http://www.acog.org/publications/patient_education/bp161.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Monthly newsletter for ACOG members. Mon, 11 May 2009 15:00:00 EDT http://www.acog.org/publications/acog_newsletters/acogToday0509.pdf resources@acog.org (ACOG Resource Center) ACOG Today Newsletter La colposcopia es una manera de ver el cuello uterino mediante un aparato amplificador especial denominado colposcopio. Este aparato ilumina dentro de la vagina y el cuello uterino. El colposcopio puede aumentar la vista normal de 2 a 60 veces. Este examen le permite al medico detectar problemas que no se pueden ver a simple vista. Este folleto explica: los motivos para hacer una colposcopia; como se realiza la colposcopia, y; que se debe esperar antes, durante y despues del procedimiento. Wed, 29 Apr 2009 11:25:00 EDT http://www.acog.org/publications/patient_education/sp135.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Los fibromas uterinos son tumores benignos (no cancerosos) en el utero. Estos tumores son el tipo mas comun de tumor que aparece en la pelvis de la mujer. En algunas mujeres, los fibromas permanecen pequenos y no producen sintomas ni problemas. En otras, no obstante, los fibromas causan problemas debido a su tamano, cantidad y ubicacion. Este folleto explicara: los tipos y las causas de los fibromas; los sintomas y las complicaciones, y; el diagnostico y tratamiento. Tue, 21 Apr 2009 16:20:00 EDT http://www.acog.org/publications/patient_education/sp074.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Surgical site infection remains the most common surgical complication. Up to 5% of patients undergoing operative procedures will develop a surgical site infection leading to a longer hospital stay and increased cost (1). One of the advances in infection control practices has been the selective use of antibiotic prophylaxis. However, indiscriminate antibiotic use has been associated with the selection of antibiotic-resistant bacteria, which have acknowledged consequences for institutions as well as for individual patients. It is important for clinicians to understand when antibiotic prophylaxis is indicated and when it is inappropriate. The purpose of this document is to review the evidence for surgical site infection prevention and appropriate antibiotic prophylaxis for gynecologic procedures. Tue, 21 Apr 2009 08:45:00 EDT http://www.acog.org/publications/educational_bulletins/pb104.cfm resources@acog.org (ACOG Resource Center) ACOG Practice Bulletin A joint statement from the American Society of Anesthesiologists and the American College of Obstetricians and Gynecologists was developed to address issues of concern to both specialties. Good obstetric care requires the availability of qualified personnel and equipment to administer general or regional anesthesia both electively and emergently. The extent and degree to which anesthesia services are available varies widely among hospitals. However, for hospitals providing obstetric care, certain optimal anesthesia goals should be sought. Tue, 21 Apr 2009 08:45:00 EDT http://www.acog.org/publications/committee_opinions/co433.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion Spinal muscular atrophy (SMA) is an autosomal recessive neurodegenerative disease that results from degeneration of spinal cord motor neurons leading to atrophy of skeletal muscle and overall weakness. In current practice, patients with a family history of SMA are being offered carrier screening for the survival motor neuron gene (SMN1) deletion mutations. Recent marketing and public awareness campaigns by laboratories and advocacy organizations are promoting widespread population-based carrier screening for SMA in the prenatal or preconception setting, regardless of family history. However, the American College of Obstetricians and Gynecologists' Committee on Genetics agrees that preconception and prenatal screening for SMA is not recommended in the general population at this time. Tue, 21 Apr 2009 08:45:00 EDT http://www.acog.org/publications/committee_opinions/co432.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion This newsletter, published 6 times per year, offers synopses of the latest developments in obstetrics, gynecology, oncology, and infertility. Provides a review article on a controversial issue, an historical perspectives, and the yearly review of the ABOG Annual Board Certification examination. Tue, 21 Apr 2009 08:45:00 EDT http://www.acog.org/publications/clinical_review/clinicalReviewv14i3.pdf resources@acog.org (ACOG Resource Center) ACOG Clinical Review El revestimiento del utero, o endometrio, se desprende con el sangrado que ocurre todos los meses durante la menstruacion. En algunas mujeres el sangrado es intenso o puede durar mas de lo normal. Para ellas, la ablacion endometrial puede ser una buena opcion de tratamiento. Este procedimiento trata el revestimiento del utero para controlar o detener el sangrado y no implica extraer el utero ni afecta a los niveles de hormonas de la mujer. Este folleto explicara: que es la ablacion endometrial; que se debe esperar antes y despues del procedimiento; los metodos de ablacion endometrial, y; los riesgos. Thu, 16 Apr 2009 16:40:00 EDT http://www.acog.org/publications/patient_education/sp134.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Laparoscopy is a type of surgery. It is used to detect and treat many health problems. Over the past 20 years, laparoscopy has become fairly common. It often can be performed as an out-patient procedure. Most patients recover from laparoscopic surgery within days. This pamphlet explains: surgery with laparoscopy; reasons for having laparoscopy; what happens during the procedure; what you can expect during your recovery, and; risks and benefits of laparoscopy. Fri, 10 Apr 2009 16:40:00 EDT http://www.acog.org/publications/patient_education/bp061.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet The second edition of ACOG's Tool Kit for Teen Care is now available to assist clinicians and health care providers in caring for adolescent patients. Developed by the ACOG Committee on Adolescent Health Care, the kit is designed to help clinicians incorporate adolescent primary and preventive health care into their practices and to provide the necessary resources. The Tool Kit for Teen Care contains resources for an adolescent-friendly office and adolescent assessment, as well as CPT coding information and educational materials on health care for girls. Among the new materials is a parent questionnaire, in addition to an adolescent visit questionnaire, and a new vaccine administration record for the clinicians use. Educational materials include 6 ACOG Patient Educational Pamphlets, sexual assault prevention and screening pocket and rolodex cards, and 36 fact sheets - 27 for teens and 9 for parents - covering a wide range of topics. Fri, 10 Apr 2009 09:30:00 EDT http://www.acog.org/departments/dept_notice.cfm?recno=7&bulletin=2595 lgoldstein@acog.org (Lisa Goldstein) Department Publications El autoexamen del seno se hace para detectar cambios que puedan causar cancer del seno. Para saber que es normal en sus senos y detectar problemas, debe hacerse un autoexamen del seno una vez al mes. Este examen es una de las mejores medidas que puede tomar por el bien de su salud. Detectar y tratar el cancer del seno en sus primeras etapas puede salvarle la vida. Este folleto explicara: como hacerse un autoexamen del seno; por que es tan importante para su salud, y; indicios de un problema. Mon, 06 Apr 2009 09:40:00 EDT http://www.acog.org/publications/patient_education/sp145.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet En la mayoria de los casos, el espermatozoide del hombre fertiliza el ovulo de la mujer en las trompas de Falopio. El ovulo fertilizado se desplaza por la trompa al revestimiento del utero, donde se implanta y comienza a desarrollarse. Un embarazo ectopico ocurre cuando el ovulo fertilizado se desarrolla fuera del utero. Dado que se encuentra fuera del utero, el embarazo ectopico no se puede desarrollar debidamente y es necesario dar tratamiento. Este folleto explicara: los sintomas del embarazo ectopico; como se diagnostica, y; como puede tratarse. Thu, 02 Apr 2009 13:00:00 EDT http://www.acog.org/publications/patient_education/sp155.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Monthly newsletter for ACOG members. Wed, 01 Apr 2009 13:05:00 EDT http://www.acog.org/publications/acog_newsletters/acogToday0409.pdf resources@acog.org (ACOG Resource Center) ACOG Today Newsletter If you have an abnormal Pap test result, your doctor may suggest that you have a loop electrosurgical excision procedure (LEEP) as part of the evaluation or for treatment. LEEP is used to remove the area containing abnormal cells from your cervix. This pamphlet explains: what an abnormal Pap test result means; how LEEP is performed; risks of the procedure; what to expect during your recovery, and; how to stay healthy. Wed, 01 Apr 2009 13:05:00 EDT http://www.acog.org/publications/patient_education/bp110.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Colposcopy is a way of looking at the cervix through a special magnifying device called a colposcope. It shines a light onto the vagina and cervix. A colposcope can enlarge the normal view by 2-60 times. This exam allows the doctor to find problems that cannot be seen by the eye alone. This pamphlet explains: reasons for colposcopy; how colposcopy is performed, and; what to expect before, during, and after the procedure. Fri, 27 Mar 2009 14:00:00 EDT http://www.acog.org/publications/patient_education/bp135.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Labor induction is the use of medications or other methods to bring on (induce) labor. Labor is induced for many reasons. Some of the methods used to induce labor also can speed up labor if it is going too slowly. Labor is induced in about 20% of pregnant women in the United States. This pamphlet will explain: the stages of labor; reasons for labor induction; how labor induction is done, and; risks of labor induction. Mon, 23 Mar 2009 15:20:00 EDT http://www.acog.org/publications/patient_education/bp154.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet A cesarean birth is the delivery of a baby through an incision (cut) made in the mother's abdomen and uterus. Doctors used to believe that if a woman had one cesarean delivery, all other babies she had should be born in the same way. Today, doctors know that many women who have had a cesarean delivery can later safely give birth though the vagina. This is called vaginal birth after cesarean (VBAC) delivery. VBAC can be a safe option for many women. However, it is not the right choice for all women, and there are some risks. This pamphlet will explain: why you may want to think about trying VBAC; what risks are involved, and; whether VBAC is right for you. Mon, 23 Mar 2009 11:50:00 EDT http://www.acog.org/publications/patient_education/bp070.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet A breast self-exam is done to detect changes that could lead to breast cancer. To learn what is normal for your breasts and to find any problems, you should do a breast self-exam once a month. It is one of the best things you can do for your health. Finding and treating breast cancer early can save your life. This pamphlet will explain: how to do a breast self-exam; why it is key to your health, and; signs of a problem. Mon, 23 Mar 2009 11:50:00 EDT http://www.acog.org/publications/patient_education/bp145.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Hereditary breast and ovarian cancer syndrome is an inherited cancer-susceptibility syndrome. The hallmarks of this syndrome are multiple family members with breast cancer or ovarian cancer or both, the presence of both breast cancer and ovarian cancer in a single individual, and early age of breast cancer onset. Clinical genetic testing for gene mutations allows physicians to more precisely identify women who are at substantial risk of breast cancer and ovarian cancer. For these individuals, screening and prevention strategies can be instituted to reduce their risks. Obstetricians and gynecologists play an important role in the identification and management of women with hereditary breast and ovarian cancer syndrome. Fri, 20 Mar 2009 15:30:00 EDT http://www.acog.org/publications/educational_bulletins/pb103.cfm resources@acog.org (ACOG Resource Center) ACOG Practice Bulletin In most cases a woman's egg is fertilized by a man's sperm in one of her fallopian tubes. The fertilized egg then moves through the tube to the lining of the uterus, where it implants and starts to grow. An ectopic pregnancy occurs when a fertilized egg grows outside of the uterus. Because it is outside of the uterus, an ectopic pregnancy cannot grow as it should and must be treated. This pamphlet will explain: symptoms of ectopic pregnancy; how it is diagnosed, and; how it may be treated. Thu, 19 Mar 2009 16:05:00 EDT http://www.acog.org/publications/patient_education/bp155.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Awaiting the birth of a baby is an exciting and anxious time. Most women give birth between 38 and 42 weeks of pregnancy. However, there is no way to know exactly when you will go into labor. Birth often occurs within 2 weeks before or after your expected due date. This pamphlet will explain: how to plan for your baby's birth; signs that labor is beginning, and; how to tell false labor and true labor apart. Wed, 18 Mar 2009 12:10:00 EDT http://www.acog.org/publications/patient_education/bp004.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet La fibrosis quistica es un trastorno genetico que ocasiona problemas respiratorios y digestivos. Se origina debido a un gen anormal que se transmite de uno de los padres a su hijo. Aunque no hay cura para la fibrosis quistica, es posible controlarla con tratamiento. Hay pruebas que determinan si una persona es portadora del gen y si hay riesgo de transmitirlo a un hijo. Este folleto explicara: la causa, los sintomas y el tratamiento de la fibrosis quistica; los factores de riesgo, y; las opciones de pruebas. Wed, 11 Mar 2009 16:35:00 EDT http://www.acog.org/publications/patient_education/sp171.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Having a baby is a joyous time for most women. But many women feel sad, afraid, angry, or anxious after childbirth. Most new mothers have these feelings in a mild form called postpartum blues. Sometimes these feelings are called "baby blues." Postpartum blues almost always go away in a few days. About 10% of new mothers have a more serious problem called postpartum depression. Postpartum depression lasts longer and is more intense. It often requires counseling and treatment. Postpartum depression can occur after any birth, not just the first. This pamphlet will help you learn about: causes of postpartum depression; how to tell if you have postpartum depression, and; what you can do to ease these feelings. Tue, 10 Mar 2009 16:10:00 EST http://www.acog.org/publications/patient_education/bp091.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Monthly newsletter for ACOG members. Mon, 09 Mar 2009 16:30:00 EST http://www.acog.org/publications/acog_newsletters/acogToday0309.pdf resources@acog.org (ACOG Resource Center) ACOG Today Newsletter Uterine fibroids are benign (not cancer) growths in the uterus. They are the most common type of growth found in a woman's pelvis. In some women, fibroids remain small and do not cause symptoms or problems. However, in some women, fibroids can cause problems because of their size, number, and location. This pamphlet will explain: Symptoms and causes; Treatments, and; How you can help relieve the pain. Thu, 05 Mar 2009 13:15:00 EST http://www.acog.org/publications/patient_education/bp074.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet The lining of the uterus--the endometrium--is shed by bleeding each month during menstruation. Some women have heavy bleeding or bleeding that lasts longer than normal. For them, endometrial ablation may be a good treatment option. This procedure treats the lining of the uterus to control or stop bleeding. It does not involve removal of the uterus and it does not affect a woman's hormone levels. Tue, 03 Mar 2009 16:30:00 EST http://www.acog.org/publications/patient_education/bp134.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Durante el embarazo, se hacen a todas las mujeres ciertos analisis de laboratorio de rutina. Estos analisis pueden ayudar al medico a detectar posibles problemas con su salud y la salud de su bebe. Es posible que deba hacerse otros examenes, segun su historial medico o familiar, sus antecedentes etnicos o resultados previos de examenes. Este folleto le informara mas sobre: los examenes que se les hace a todas las mujeres embarazadas; por que y cuando se realizan estos examenes, y; otros examenes que pueden ser necesarios. Thu, 26 Feb 2009 12:50:00 EST http://www.acog.org/publications/patient_education/sp133.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Stillbirth is one of the most common adverse pregnancy outcomes, complicating 1 in 160 deliveries in the United States. Approximately 25,000 stillbirths at 20 weeks or greater of gestation are reported annually (1). The purpose of this bulletin is to review the current information on stillbirth, including definitions and management, the evaluation of a stillbirth, and strategies for prevention. Fri, 20 Feb 2009 08:45:00 EST http://www.acog.org/publications/educational_bulletins/pb102.cfm resources@acog.org (ACOG Resource Center) ACOG Practice Bulletin Preimplantation genetic screening differs from preimplantation genetic diagnosis for single gene disorders and was introduced for the detection of chromosomal aneuploidy. Current data does not support a recommendation for preimplantation genetic screening for aneuploidy using fluorescence in situ hybridization solely because of maternal age. Also, preimplantation genetic screening for aneuploidy does not improve in vitro fertilization success rates and may be detrimental. At this time there are no data to support preimplantation genetic screening for recurrent unexplained miscarriage and recurrent implantation failures; its use for these indications should be restricted to research studies with appropriate informed consent. Fri, 20 Feb 2009 08:45:00 EST http://www.acog.org/publications/committee_opinions/co430.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion Significant health disparities exist for rural women in all categories of women's health, including obstetric and gynecologic outcomes and access to care. Minority women living in rural areas may face even greater risks based on their combined characteristics. Many rural areas have limited numbers of health care providers, particularly those who provide obstetric and gynecologic care. Generalizations regarding rural America are difficult because of the heterogeneity of rural areas within the United States and even within the borders of a single state. Health professionals are encouraged to engage in activities to diminish health disparities for rural women. Fri, 20 Feb 2009 08:45:00 EST http://www.acog.org/publications/committee_opinions/co429.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion This newsletter, published 6 times per year, offers synopses of the latest developments in obstetrics, gynecology, oncology, and infertility. Provides a review article on a controversial issue, an historical perspectives, and the yearly review of the ABOG Annual Board Certification examination. Fri, 20 Feb 2009 08:45:00 EST http://www.acog.org/publications/clinical_review/clinicalReviewv14i2.pdf resources@acog.org (ACOG Resource Center) ACOG Clinical Review Tener un bebe es un acontecimiento feliz para la mayoria de las mujeres. Muchas otras, sin embargo, se sienten tristes, temerosas, enojadas o ansiosas despues de dar a luz. La mayoria de las madres de recien nacidos pueden presentar estos sentimientos en un grado leve que se denomina tristeza despues del parto. A veces, a estos sentimientos se les conoce como melancolia despues del parto. La tristeza despues del parto casi siempre desaparece al cabo de unos dias. Sin embargo, aproximadamente el 10% de las madres de recien nacidos presentan un problema mas grave que se denomina depresion despues del parto. La depresion despues del parto dura mas tiempo y es mas intensa. A menudo requiere asistencia psicologica y tratamiento. La depresion despues del parto puede ocurrir despues de cualquier parto, no solamente el primero. Este folleto le ayudara a obtener mas informacion sobre: las causas de la depresion despues del parto; como saber si padece depresion despues del parto, y; que puede hacer para aliviar estos sentimientos. Thu, 05 Feb 2009 15:10:00 EST http://www.acog.org/publications/patient_education/sp091.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Cada ano, aproximadamente 1.3 millones de mujeres en Estados Unidos tienen un aborto para poner fin a un embarazo. El procedimiento conlleva poco riesgo cuando se hace oportunamente y en el ambiente adecuado. Realizar un aborto es una decision muy importante que se debe considerar cuidadosamente. Puede ser de ayuda hablar con su pareja, un familiar o un amigo cercano. Su medico o asesor puede responder a preguntas y explicar el procedimiento. Este folleto explica: Los datos medicos acerca del aborto inducido; Los tipos de abortos, y; Como se realizan los abortos. Wed, 04 Feb 2009 12:05:00 EST http://www.acog.org/publications/patient_education/sp043.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Monthly newsletter for ACOG members. Thu, 29 Jan 2009 16:00:00 EST http://www.acog.org/publications/acog_newsletters/acogToday0209.pdf resources@acog.org (ACOG Resource Center) ACOG Today Newsletter La violencia domestica, o causada por la pareja intima, es probablemente uno de los problemas de salud mas comunes, pero menos denunciados. Esto es de especial preocupacion para las mujeres dado que la mayoria de victimas de abuso son mujeres. La violencia domestica no reconoce barreras economicas, de educacion, raciales, religiosas o de edad. El abuso ocurre en todo tipo de parejas que tienen relaciones intimas. Es mas comun en parejas conformadas por hombre y mujer. Este folleto explicara lo siguiente: Tipos de abuso; Que hacer si una persona que usted conoce es victima de abuso, y; Como obtener ayuda. Thu, 29 Jan 2009 12:55:00 EST http://www.acog.org/publications/patient_education/sp083.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Las nauseas y el vomito son usuales durante el embarazo, en especial durante la primera parte del embarazo. Con frecuencia, se le llama "nauseas del embarazo", aunque pueden ocurrir en la manana o a cualquier hora del dia. La mayoria de las causas de las nauseas y el vomito no son perjudiciales. No obstante, cuando las nauseas y el vomito son intensos y persistentes, pueden afectar su salud. Este folleto le ayudara a obtener mas informacion sobre: Nauseas y vomito que son normales durante el embarazo; Como se alivian las nauseas y el vomito, y; Cuando es necesario un tratamiento. Mon, 26 Jan 2009 16:35:00 EST http://www.acog.org/publications/patient_education/sp126.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Cystic fibrosis (CF) is a genetic disorder that causes problems with breathing and digestion. It is caused by an abnormal gene that is passed from parent to child. There is no cure for CF, but it can be treated. Testing can be done to see if a person carries the gene and if there is a risk of passing it on to a child. This pamphlet will explain: cause, symptoms, and treatment of CF; risk factors, and; testing options. Fri, 23 Jan 2009 10:35:00 EST http://www.acog.org/publications/patient_education/bp171.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Most women have at least one ultrasound examination during pregnancy. The purpose of this document is to present evidence regarding the methodology of, indications for, benefits of, and risks associated with obstetric ultrasonography in specific clinical situations. Portions of this document were developed collaboratively with the American College of Radiology and the American Institute of Ultrasound in Medicine. The sections that address physician qualifications and responsibilities, documentation, quality control, infection control, and patient safety contain recommendations from the American College of Obstetricians and Gynecologists. Fri, 23 Jan 2009 10:15:00 EST http://www.acog.org/publications/educational_bulletins/pb101.cfm resources@acog.org (ACOG Resource Center) ACOG Practice Bulletin Critical care in pregnancy is a field that remains unevenly researched. Although there is a body of evidence to guide many recommendations in critical care, limited research specifically addresses obstetric critical care. The purpose of this document is to review the available evidence, propose strategies for care, and highlight the need for additional research. Much of the review will, of necessity, focus on general principles of critical care, extrapolating where possible to obstetric critical care. Fri, 23 Jan 2009 10:15:00 EST http://www.acog.org/publications/educational_bulletins/pb100.cfm resources@acog.org (ACOG Resource Center) ACOG Practice Bulletin Women in same-sex relationships encounter barriers to health care that include concerns about confidentiality and disclosure, discriminatory attitudes and treatment, limited access to health care and health insurance, and often a limited understanding as to what their health risks may be. Lesbians and their families also are adversely affected by the lack of legal recognition of their relationships. Tangible harm comes from the lack of financial and health care protections that are granted to legal spouses, and children are harmed by the lack of protections afforded married families. The American College of Obstetricians and Gynecologists endorses equitable treatment for lesbians and their families, not only for direct health care needs but also for indirect health care issues; this should include the same legal protections afforded married couples. Fri, 23 Jan 2009 10:15:00 EST http://www.acog.org/publications/committee_opinions/co428.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion The World Health Organization estimates that 67,000 women, mostly in developing countries, die each year from untreated or inadequately treated abortion complications. Postabortion care, a term commonly used by the international reproductive health community, refers to a specific set of services for women experiencing problems from all types of spontaneous or induced abortion. There is increasing evidence that misoprostol is a safe, effective, and acceptable method to achieve uterine evacuation for women needing postabortion care. To reduce maternal mortality, availability of postabortion care services must be increased. Misoprostol must be readily available especially for women who do not otherwise have access to postabortion care. Nurses and midwives can safely provide first-line postabortion care services, including in outpatient settings, provided they receive appropriate training and support. Access to contraception and safe abortion services prevents complications from unsafe abortion and decreases the need for postabortion care. It is much less expensive and far better for women's health to prevent the problem of unsafe abortion rather than to treat resulting complications. Fri, 23 Jan 2009 10:15:00 EST http://www.acog.org/publications/committee_opinions/co427.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion Domestic, or intimate partner, violence may be one of America's most widespread health problems--and yet one of the least reported. It is of special concern to women because most abuse victims are female. Domestic violence knows no economic, educational, racial, religious, or age barriers. Abuse happens in intimate relationships between couples from all walks of life. It is most common in couples who are male and female. This pamphlet will explain: types of abuse; what to do if you or someone you know is abused, and; how to get help. Thu, 15 Jan 2009 10:35:00 EST http://www.acog.org/publications/patient_education/bp083.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Nausea and vomiting are common during pregnancy, especially during the first part of pregnancy. This is often called "morning sickness," although it can occur at any time of the day. Most cases of nausea and vomiting are not harmful. However, when nausea and vomiting are severe and persist, they can affect your health. This pamphlet will help you learn more about: nausea and vomiting that is normal during pregnancy; how nausea and vomiting can be relieved, and; when treatment is needed. Tue, 13 Jan 2009 15:50:00 EST http://www.acog.org/publications/patient_education/bp126.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Muchas enfermedades que conocemos como enfermedades de la infancia tambien pueden afectar a los adultos. Incluso pueden causar problemas en las embarazadas o en sus bebes. Existen algunos pasos que usted puede tomar antes y durante el embarazo para evitar estos problemas. Este folleto explica: Los tipos de enfermedades de la infancia que pueden provocar problemas en el embarazo; Como prevenir las enfermedades de la infancia, y; Que hacer si esta expuesta a una infeccion. Thu, 08 Jan 2009 15:30:00 EST http://www.acog.org/publications/patient_education/sp157.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Monthly newsletter for ACOG members. Mon, 05 Jan 2009 15:15:00 EST http://www.acog.org/publications/acog_newsletters/acogToday0109.pdf resources@acog.org (ACOG Resource Center) ACOG Today Newsletter Muchas mujeres sufren de infecciones de las vias urinarias en algun momento en la vida. Algunas de ellas presentan estas infecciones varias veces y les ocurren a menudo. La mayoria de las infecciones de las vias urinarias no son enfermedades graves y pueden tratarse facilmente con antibioticos para aliviar rapido los sintomas. Este folleto explicara: las causas de las infecciones de las vias urinarias; los sintomas y el tratamiento, y; como se pueden evitar las infecciones de las vias urinarias. Tue, 23 Dec 2008 10:30:00 EST http://www.acog.org/publications/patient_education/sp050.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Undocumented immigrants are less likely than other residents of the United States to have health insurance. Their access to publicly funded health programs has become increasingly limited since the passage of welfare reform in 1996 and varies from state to state. This is reflected in less preventive health care, including prenatal care, and poorer health outcomes, including those associated with childbirth. The U.S.-born children of undocumented immigrant women are U.S. citizens, and the nation's public health is enhanced by assuring that all who reside in the United States, including undocumented immigrants, have access to quality health care. Mon, 22 Dec 2008 11:30:00 EST http://www.acog.org/publications/committee_opinions/co425.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion Despite a decrease in abortion rates over the past decade, numerous political, social, and provider barriers limit access to abortion services. Barriers include state restrictions and mandates limiting access, lack of public funding for abortion services, and the decrease in abortion providers. Abortion education and training are limited in medical schools and in residency programs. The American College of Obstetricians and Gynecologists supports education in family planning and abortion for both medical students and residents and abortion training among residents. In addition, the American College of Obstetricians and Gynecologists supports availability of reproductive health services for all women, including strategies to reduce unintended pregnancy and to improve access to safe abortion services. Mon, 22 Dec 2008 11:30:00 EST http://www.acog.org/publications/committee_opinions/co424.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion Applying the principles of motivational interviewing to everyday patient interactions has been proved effective in eliciting "behavior change" that contributes to positive health outcomes and improved patient-physician communication. Current Procedural Terminology codes are available to aid in obtaining reimbursement for time spent engaging patients in motivational interviewing for some conditions. Mon, 22 Dec 2008 11:30:00 EST http://www.acog.org/publications/committee_opinions/co423.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion This newsletter, published 6 times per year, offers synopses of the latest developments in obstetrics, gynecology, oncology, and infertility. Provides a review article on a controversial issue, an historical perspectives, and the yearly review of the ABOG Annual Board Certification examination. Mon, 22 Dec 2008 11:30:00 EST http://www.acog.org/publications/clinical_review/clinicalReviewv14i1.pdf resources@acog.org (ACOG Resource Center) ACOG Clinical Review Parte del proceso de crecer es aprender a cuidar de tu cuerpo. Esto quiere decir tomar buenas decisiones con respecto a tu salud, evitar todo lo que te pueda causar dano y acudir a un medico o a otro proveedor de atencion medica para el cuidado de rutina. Si nunca has tenido un examen ginecologico, es posible que tengas preguntas sobre lo que sucedera en la primera consulta. Este folleto tiene por objeto explicar: lo que puedes esperar en una consulta ginecologica; los examenes que posiblemente te hagan, y; los temas especificos que se pueden tratar. Thu, 18 Dec 2008 14:30:00 EST http://www.acog.org/publications/patient_education/sp150.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet During pregnancy, all women have certain routine lab tests. These tests can help your doctor detect possible problems with your health and your baby's health. You also may have other tests, depending on your medical history, family or ethnic background, or previous test results. This pamphlet will tell you more about: tests that are done on all pregnant women; why and when these tests are done, and; other tests that may be needed. Wed, 10 Dec 2008 12:30:00 EST http://www.acog.org/publications/patient_education/bp133.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Many women have a urinary tract infection (UTI) at some point during their lives. Some women will have repeat infections and may have them often. Most UTIs are not serious. They are easy to treat with antibiotics, and symptoms can be relieved quickly. This pamphlet will explain: causes of UTIs; symptoms and treatment, and; how UTIs can be prevented. Tue, 09 Dec 2008 10:30:00 EST http://www.acog.org/publications/patient_education/bp050.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Un embarazo normal es de aproximadamente 40 semanas. La perdida de un embarazo antes de las 20 semanas se llama perdida gestacional temprana. Comunmente la perdida es un aborto (llamado aborto espontaneo por los medicos). Una forma menos comun de perdida gestacional es el embarazo molar. La perdida de un embarazo-sin importar la duracion-involucra mas que la perdida de un feto. Para muchas mujeres, el aborto produce tambien sentimientos de perdida y pesar. Este folleto explica: Algunas causas de perdida gestacional temprana; Signos y sintomas de perdida gestacional, y; Que esperar despues de la perdida. Thu, 04 Dec 2008 16:00:00 EST http://www.acog.org/publications/patient_education/sp090.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Una dieta saludable y ejercicio periodico aumentaran su nivel de energia y le ayudaran a tener un mejor estilo de vida. Tener un bebe y cuidar del recien nacido es un trabajo duro. Tardara un tiempo para recobrar su fuerza despues de la tension del embarazo y nacimiento. Usted debe permitirle tiempo al cuerpo para recuperarse. Pero, en cuanto usted se sienta capaz, hable con su medico sobre cuando puede empezar un programa de ejercicio. Este folleto le dira sobre: Los beneficios de ejercicio; Buenos ejercicios para conseguir el bienestar, y; Programas para continuarlos. Tue, 02 Dec 2008 14:45:00 EST http://www.acog.org/publications/patient_education/sp131.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Recent evidence has shown that the risk of malignant and premalignant cervical disease and human papillomavirus (HPV) infections varies significantly with age (1, 2). Furthermore, evidence now shows that treatment for cervical disease carries significant risk for future pregnancies (3-7). These factors have led to a re-evaluation of the guidelines for the management of premalignant cervical disease. The purpose of this document is to define strategies for diagnosis and management of abnormal cervical cytology and histology results. In this document, HPV refers to high-risk oncogenic forms of the virus. Sun, 30 Nov 2008 11:45:00 EST http://www.acog.org/publications/educational_bulletins/pb099.cfm resources@acog.org (ACOG Resource Center) ACOG Practice Bulletin Drug and alcohol abuse is a major health problem for American women regardless of their socioeconomic status, race, ethnicity, and age. It is costly to individuals and to society. Obstetrician-gynecologists have an ethical obligation to learn and use a protocol for universal screening questions, brief intervention, and referral to treatment in order to provide patients and their families with medical care that is state-of-the-art, comprehensive, and effective. In this Committee Opinion, the American College of Obstetricians and Gynecologists' Committee on Ethics proposes an ethical rationale for this protocol in both obstetric and gynecologic practice, offers a practical aid for incorporating such care, and provides guidelines for resolving common ethical dilemmas related to drug and alcohol use that arise in the clinical setting. Sun, 30 Nov 2008 11:45:00 EST http://www.acog.org/publications/committee_opinions/co422.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion The goal of sonohysterography is to visualize the endometrial cavity in more detail than is possible with routine transvaginal ultrasound. The procedure consists of the manual injection of sterile fluid under real-time ultrasonographic imaging. The most common indication for sonohysterography is abnormal uterine bleeding. The procedure should not be performed in a woman who is pregnant or who could be pregnant, or who has a pelvic infection or unexplained pelvic tenderness. Physicians who perform or supervise diagnostic sonohysterography should be skilled in vaginal ultrasonography and transcervical placement of catheters; should have training, experience, and demonstrated competence in gynecologic ultrasonography and sonohysterography; and should keep careful records. Portions of this document were developed jointly with the American College of Radiology and the American Institute of Ultrasound in Medicine. Sun, 30 Nov 2008 11:45:00 EST http://www.acog.org/publications/technology_assessment/ta005.cfm resources@acog.org (ACOG Resource Center) ACOG Technology Assessment El monitoreo fetal no puede impedir un problema. Sin embargo, puede alertar a su medico o enfermera; estas senales pueden permitirles tomar los pasos adecuados para ayudar a su bebe. Este folleto le explicara: Los tipos de monitoreo fetal; Que pueden significar ciertos patrones, y; Y que riesgos pueden estar involucrados. Sun, 30 Nov 2008 11:45:00 EST http://www.acog.org/publications/patient_education/sp015.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Aproximadamente 10% de nuevas madres tienen un problema mayor llamado la depresion posparto. La depresion posparto dura mas mucho tiempo y es mas intensa. Requiere a menudo de consejo y tratamiento. La depresion posparto puede ocurrir despues de cualquier nacimiento, no solo el primero. Este folleto le ayudara a aprender sobre: Las causas de depresion posparto, y; Que puede hacer para aliviar estos sentimientos. Sun, 30 Nov 2008 11:45:00 EST http://www.acog.org/publications/patient_education/sp091.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Las celulas en el cervix crecen y cambian todo el tiempo. A veces estas celulas cambian hacia la anormalidad, lo cual puede indicar una advertencia temprana de que el cancer puede ocurrir. Y cuando se demuestra en las pruebas que usted tiene celulas anormales, la opcion que su medico le puede ofrecer es el procedimiento excisional. Este folleto explica: Como se realiza el LEEP (Procedimiento electro-quirurgico de excision cervical); Que esperar durante el procedimiento, y; Como continuar saludable. Sun, 30 Nov 2008 11:45:00 EST http://www.acog.org/publications/patient_education/sp110.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet La histeroscopia es una tecnica que se usa para ver dentro del utero. El histeroscopio es un instrumento delgado parecido a un telescopio que se coloca dentro del utero a traves de la vagina y el cuello uterino. Esta tecnica puede ayudar al medico a diagnosticar o tratar problemas uterinos. Este folleto explicara: los motivos para hacer una histeroscopia; lo que sucede durante el procedimiento, y; los riesgos del procedimiento. Mon, 17 Nov 2008 16:00:00 EST http://www.acog.org/publications/patient_education/sp084.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Monthly newsletter for ACOG members. Wed, 12 Nov 2008 16:45:00 EST http://www.acog.org/publications/acog_newsletters/acogToday1108.pdf resources@acog.org (ACOG Resource Center) ACOG Today Newsletter Part of growing up is learning to take care of your body. This means making good choices for your health, avoiding things that can harm you, and seeing a doctor or other health care provider for routine care. If you have never had a gynecologic exam before, you may have questions about what will happen at your first visit. This pamphlet will explain: what to expect at a gynecologic visit; what exams may be done, and; what special concerns may be discussed. Wed, 12 Nov 2008 12:05:00 EST http://www.acog.org/publications/patient_education/bp150.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Statements issued by the ACOG Executive Board. Mon, 10 Nov 2008 15:25:00 EST http://www.acog.org/publications/policy_statements/sop0811.cfm resources@acog.org (ACOG Resource Center) ACOG Statements of Policy The recommendations for endocarditis prophylaxis from the American Heart Association have changed for three main reasons: 1) most cases of endocarditis are not attributable to an invasive procedure but rather are the result of randomly occurring bacteremia from routine daily activities; 2) prophylaxis may only prevent a small number of cases of infective endocarditis in women undergoing genitourinary procedures; and 3) the risk of antibiotic associated adverse events exceeds the benefit, if any, from prophylactic antibiotic therapy. The specific changes pertinent to the obstetrician-gynecologist are discussed. Fri, 31 Oct 2008 09:35:00 EDT http://www.acog.org/publications/committee_opinions/co421.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion The effect of menopausal hormone therapy on coronary heart disease has been the subject of much concern. The Heart and Estrogen/Progestin Replacement Study (HERS) and Women's Health Initiative studies found an increased risk of cardiovascular events with conjugated equine estrogen and medroxyprogesterone acetate use. However, recent evidence suggests that women in early menopause who are in good cardiovascular health are at low risk of adverse cardiovascular outcomes and as such should be considered candidates for the use of conjugated equine estrogen or conjugated equine estrogen and medroxyprogesterone acetate for relief of menopausal vasomotor symptoms. Hormone therapy use should be limited to the treatment of menopausal symptoms at the lowest effective dosage over the shortest duration possible, and continued use should be reevaluated on a periodic basis. Fri, 31 Oct 2008 09:35:00 EDT http://www.acog.org/publications/committee_opinions/co420.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion This newsletter, published 6 times per year, offers synopses of the latest developments in obstetrics, gynecology, oncology, and infertility. Provides a review article on a controversial issue, an historical perspectives, and the yearly review of the ABOG Annual Board Certification examination. Fri, 31 Oct 2008 09:35:00 EDT http://www.acog.org/publications/clinical_review/clinicalReviewv13i6.pdf resources@acog.org (ACOG Resource Center) ACOG Clinical Review Hay varias causas que pueden producir sangrado vaginal durante el embarazo. Algunas son graves y otras no. El sangrado vaginal puede ocurrir en las primeras o ultimas etapas del embarazo. A menudo cuando el sangrado es leve cesa por su cuenta. A veces, el sangrado puede poner en peligro a usted o al feto. Usted debe llamar a su medico o consultar a un profesional de la salud siempre que se presente sangrado vaginal. Este folleto explicara: las causas del sangrado; las senales cuando existen problemas, y; las medidas que se pueden tomar. Mon, 27 Oct 2008 16:10:00 EDT http://www.acog.org/publications/patient_education/sp038.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Hysteroscopy is a technique used to look inside the uterus. A hysteroscope is a thin, telescope-like device that is placed into the uterus through the vagina and cervix. It may help a doctor diagnose or treat a uterine problem. This pamphlet will explain: reasons for having hysteroscopy; what happens during the procedure, and; risks of the procedure. Fri, 24 Oct 2008 15:40:00 EDT http://www.acog.org/publications/patient_education/bp084.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet El sangrado uterino anormal es una de las razonas por las cuales las mujeres acuden comunmente a sus medicos. Este sangrado puede ocurrir a cualquier edad y debido a muchas causas. A veces, es posible tratarlo facilmente, mientras que en otras ocasiones, el sangrado es mas grave. El primer paso del tratamiento consiste en determinar la causa. Este folleto explicara: las causas del sangrado anormal; como se diagnostica, y; como se trata. Thu, 23 Oct 2008 15:25:00 EDT http://www.acog.org/publications/patient_education/sp095.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Vaginal bleeding in pregnancy has many causes. Some are serious and some are not. Bleeding can occur early or later in pregnancy. Slight bleeding often stops on its own. Sometimes, bleeding may pose a risk to you or your fetus. You should call your doctor or seek medical advice any time that bleeding occurs. This pamphlet will explain the causes of bleeding, signs of problems, and what can be done. Thu, 16 Oct 2008 09:00:00 EDT http://www.acog.org/publications/patient_education/bp038.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Si esta embarazada y tiene el virus de inmunodeficiencia humana (VIH), puede contagiar a su bebe con este virus. No obstante, hay medidas que puede tomar durante y despues del embarazo para mantenerse sana y evitar que su bebe se infecte con el VIH. Este folleto explicara: Como puede el VIH afectar a usted y su bebe; Maneras para reducir el riesgo que corre su bebe, y; Por que debe seguir con su tratamiento despues de que nazca el bebe. Tue, 14 Oct 2008 15:10:00 EDT http://www.acog.org/publications/patient_education/sp113.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Las enfermedades de transmision sexual son infecciones que se contraen por medio del contacto sexual. Excepto por los resfriados y la gripe, las enfermedades de transmision sexual son las enfermedades contagiosas mas comunes (que se propagan mas facilmente) en Estados Unidos. Cada ano se notifican millones de casos nuevos de estas enfermedades. Aunque es posible tratar y curar algunas enfermedades de transmision sexual, ese no es el caso con otras. La prevencion es la clave para combatir las enfermedades de transmision sexual. Al informarse sobre estas enfermedades, podra tomar medidas para proteger su salud. Este folleto explicara: Los tipos de enfermedades de transmision sexual y sus sintomas; Los riesgos de contraer una enfermedad de transmision sexual, y; Como prevenir las enfermedades de transmision sexual. Thu, 09 Oct 2008 16:30:00 EDT http://www.acog.org/publications/patient_education/sp009.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet El utero esta integrado por tres partes: la pared muscular, el endometrio (revestimiento) y el cuello uterino (abertura). El cancer del utero afecta adversamente al musculo y endometrio, y en algunos casos, al cuello uterino. Es importante estar al tanto de los factores de riesgo y las senales de advertencia. Si el cancer se detecta y trata en sus primeras etapas, es posible curar tanto como a 9 mujeres de cada 10 afectadas por este cancer. Thu, 02 Oct 2008 12:35:00 EDT http://www.acog.org/publications/patient_education/sp097.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Monthly newsletter for ACOG members. Tue, 30 Sep 2008 13:55:00 EDT http://www.acog.org/publications/acog_newsletters/acogToday1008.pdf resources@acog.org (ACOG Resource Center) ACOG Today Newsletter Preterm birth affects 12% of all births in the United States. Recent studies support the hypothesis that progesterone supplementation reduces preterm birth in a select group of women. Despite the apparent benefits of progesterone, the ideal progesterone formulation is unknown. The American College of Obstetricians and Gynecologists' Committee on Obstetric Practice and the Society for Maternal Fetal Medicine believe that further studies are needed to evaluate the optimal preparation, dosage, route of administration, and other indications for the use of progesterone for the prevention of preterm delivery. Based on current knowledge, it is important to offer progesterone for pregnancy prolongation to only women with a documented history of a previous spontaneous birth at less than 37 weeks of gestation. Tue, 30 Sep 2008 08:45:00 EDT http://www.acog.org/publications/committee_opinions/co419.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion Abnormal uterine bleeding is one of the most common reasons women see their doctors. It can occur at any age and has many causes. Some are easily treated, while others are more serious. Finding the cause is the first step in treatment. This pamphlet will explain: causes of abnormal bleeding; how it is diagnosed, and; how it can be treated. Thu, 25 Sep 2008 17:00:00 EDT http://www.acog.org/publications/patient_education/bp095.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet El revestimiento del utero se denomina endometrio. A veces, el tejido endometrial se desarrolla en otra parte del cuerpo. Cuando esto sucede, se denomina endometriosis. La endometriosis puede causar dolor antes y durante el periodo menstrual. En algunas mujeres, el dolor puede ser leve. En otras, puede ser intenso. La endometriosis tambien puede producir infertilidad. Thu, 25 Sep 2008 17:00:00 EDT http://www.acog.org/publications/patient_education/sp013.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Episiotomy is the most common operative procedure that most obstetricians will perform in their lifetime. Because it is so common and considered minor surgery, teaching students or interns the principles and techniques usually is left to the most junior of residents. As a result, the Residency Review Committee for Obstetrics and Gynecology (RRC) asked the American College of Obstetricians and Gynecologists (ACOG) to prepare a teaching aid for all residents, but especially those with the least experience. The result is this monograph. Tue, 23 Sep 2008 12:30:00 EDT http://www.acog.org/publications/episiotomy tdineen@acog.org (Thomas Dineen) ACOG Monograph La episiotomia es el procedimiento quirurgico mas comun que llevaran a cabo la mayoria de los obstetras en sus vidas. Debido a que es tan comun y se considera una cirugia menor, generalmente se deja a los residentes mas nuevos la ensenanza de los alumnos o medicos internos sobre los principios y las tecnicas. Como resultado, el Comite Revisor de Residencia para Obstetricia y Ginecologia (RRC, por sus siglas en ingles) solicito al Colegio Norteamericano de Obstetras y Ginecologos (ACOG, por sus siglas en ingles) que prepare una ayuda para la ensenanza para todos los residentes, pero especialmente para aquellos que cuentan con la menor experiencia. El resultado es la presente monografia. Tue, 23 Sep 2008 12:30:00 EDT http://www.acog.org/publications/episiotomy tdineen@acog.org (Thomas Dineen) ACOG Monograph If you are pregnant and have human immunodeficiency virus (HIV), it can be passed to your baby. But there are steps you can take to stay healthy during and after pregnancy and help prevent your baby from becoming infected with HIV. This pamphlet will explain: How HIV can affect you and your baby; Ways to reduce the risk to your baby, and; Why you should continue treatment after the baby is born. Wed, 10 Sep 2008 13:30:00 EDT http://www.acog.org/publications/patient_education/bp113.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Respiratory difficulties are common in neonates born with immature lung development. Assessment of fetal lung maturity is an important component in determining the timing of delivery in certain patients who experience complications during pregnancy. Enhancement of fetal pulmonary function with the use of antenatal steroids and the administration of surfactant lessens the prevalence and severity of neonatal respiratory distress syndrome (RDS) and its sequelae. However, RDS remains a major clinical issue. Commonly used tests to determine fetal lung maturity are reviewed in this Practice Bulletin. Fri, 29 Aug 2008 10:30:00 EDT http://www.acog.org/publications/educational_bulletins/pb097.cfm resources@acog.org (ACOG Resource Center) ACOG Practice Bulletin Early identification and treatment of all pregnant women with human immunodeficiency virus (HIV) is the best way to prevent neonatal disease and improve the woman's health. Human immunodeficiency virus screening is recommended for all pregnant women after they are notified that they will be tested for HIV infection as part of the routine panel of prenatal blood tests unless they decline the test (ie, opt-out screening). Repeat testing in the third trimester, or rapid HIV testing at labor and delivery as indicated or both also are recommended as additional strategies to further reduce the rate of perinatal HIV transmission. The American College of Obstetricians and Gynecologists makes the following recommendations: obstetrician-gynecologists should follow opt-out prenatal HIV screening where legally possible; repeat conventional or rapid HIV testing in the third trimester is recommended for women in areas with high HIV prevalence, women known to be at high risk for acquiring HIV infection, and women who declined testing earlier in pregnancy; rapid HIV testing should be used in labor for women with undocumented HIV status following opt-out screening; and if a rapid HIV test result in labor is positive, immediate initiation of antiretroviral prophylaxis should be recommended without waiting for the results of the confirmatory test. Fri, 29 Aug 2008 10:30:00 EDT http://www.acog.org/publications/committee_opinions/co418.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion Noncoital sexual behaviors, which include mutual masturbation, oral sex, and anal sex, are common expressions of human sexuality. Couples may engage in noncoital sexual activity instead of penile-vaginal intercourse hoping to reduce the risk of sexually transmitted diseases and unintended pregnancy. Although these behaviors carry little or no risk of pregnancy, women engaging in noncoital behaviors may be at risk of acquiring sexually transmitted diseases. Practitioners can assist by assessing patient risk and providing risk reduction counseling for those participating in noncoital sexual activities. Fri, 29 Aug 2008 10:30:00 EDT http://www.acog.org/publications/committee_opinions/co417.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion The United States is one of the few industrialized nations in the world that do not guarantee health care for their populations. Access to health care for all women is of paramount concern to obstetrician-gynecologists and the American College of Obstetricians and Gynecologists. Pregnant women and infants are among the most vulnerable populations in the United States and the American College of Obstetricians and Gynecologists believes that providing them with full insurance coverage and access to health care must be a primary step in the process of providing coverage for all individuals within the U.S. borders. Health care professionals can play a pivotal role in improving access to needed health care by helping society and our political representatives understand the importance of broadening health insurance coverage. Fri, 29 Aug 2008 10:30:00 EDT http://www.acog.org/publications/committee_opinions/co416.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion Although depot medroxyprogesterone acetate (DMPA) is associated with bone mineral density (BMD) loss during use, current evidence suggests that partial or full recovery of BMD occurs at the spine and at least partial recovery occurs at the hip after discontinuation of DMPA. Given the efficacy of DMPA, particularly for populations such as adolescents for whom contraceptive adherence can be challenging or for those who feel they could not comply with a daily contraceptive method or a method that must be used with each act of intercourse, the possible adverse effects of DMPA must be balanced against the significant personal and public health impact of unintended pregnancy. Concerns regarding the effect of DMPA on BMD should neither prevent practitioners from prescribing DMPA nor limit its use to 2 consecutive years. Practitioners should not perform BMD monitoring solely in response to DMPA use because any observed short-term loss in BMD associated with DMPA use may be recovered and is unlikely to place a woman at risk of fracture during use or in later years. Fri, 29 Aug 2008 10:30:00 EDT http://www.acog.org/publications/committee_opinions/co415.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion This newsletter, published 6 times per year, offers synopses of the latest developments in obstetrics, gynecology, oncology, and infertility. Provides a review article on a controversial issue, an historical perspectives, and the yearly review of the ABOG Annual Board Certification examination. Fri, 29 Aug 2008 10:30:00 EDT http://www.acog.org/publications/clinical_review/clinicalReviewv13i5.pdf resources@acog.org (ACOG Resource Center) ACOG Clinical Review Monthly newsletter for ACOG members. Fri, 29 Aug 2008 10:30:00 EDT http://www.acog.org/publications/acog_newsletters/acogToday0908.pdf resources@acog.org (ACOG Resource Center) ACOG Today Newsletter The uterus is made up of three parts: the muscle wall, the endometrium (lining), and the cervix (opening). Cancer of the uterus affects the muscle and endometrium, and in some cases, the cervix. It is good to know the risk factors and the warning signs. If the cancer is found and treated early, as many as 9 out of every 10 women who have it can be cured. This pamphlet will explain: Risk factors for uterine cancer; Symptoms, and; How it is treated. Thu, 28 Aug 2008 15:15:00 EDT http://www.acog.org/publications/patient_education/bp097.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Una dieta balanceada es una parte esencial de una buena salud en todo momento de su vida. Durante el embarazo, su dieta es aun mas importante. Durante el embarazo, su dieta es aun mas importante. Los alimentos que ingiere son la fuente principal de nutrientes para su bebe. A medida que su bebe se desarrolla, usted necesitara una mayor cantidad de la mayoria de los nutrientes. Este folleto la ayudara a informarse mas sobre: Buenas elecciones alimentarias para usted y su bebe; Nutrientes que necesitara, y; Un aumento de peso saludable. Thu, 28 Aug 2008 10:30:00 EDT http://www.acog.org/publications/patient_education/sp001.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet The lining of the uterus is called the endometrium. Sometimes, endometrial tissue grows elsewhere in the body. When this happens it is called endometriosis. Endometriosis can cause pain before and during the menstrual period. For some women, the pain is mild. For others, it can be severe. Endometriosis also may lead to infertility. This pamphlet will explain: The symptoms of endometriosis; How it is diagnosed, and; How it may be treated. Tue, 19 Aug 2008 11:35:00 EDT http://www.acog.org/publications/patient_education/bp013.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Uno de los momentos mas especiales en la vida de una madre es cuando ella amamanta a su bebe. Los expertos estan de acuerdo que el amamantamiento es mejor. Crea un lazo entre usted y su bebe y proporciona una mejor nutricion a su infante. Tambien protege contra muchas enfermedades. Este folleto le explicara sobre: Los beneficios de amamantar; Buenas posiciones para amamantar, y; Sugerencias sobre la dieta, regreso al trabajo y anticoncepcion. Wed, 13 Aug 2008 16:40:00 EDT http://www.acog.org/publications/patient_education/sp029.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Uterine leiomyomas (also called fibroids) are the most common solid pelvic tumors in women and the leading indication for hysterectomy. Although many women with uterine leiomyomas are asymptomatic and can be monitored without treatment, some will require more active measures. Hysterectomy remains the most common surgical treatment for leiomyomas because it is the only definitive treatment and eliminates the possibility of recurrence. Many women seek an alternative to hysterectomy because they desire future childbearing or wish to retain their uteri even if they have completed childbearing. As alternatives to hysterectomy become increasingly available, the efficacies and risks of these treatments are important to delineate. The purpose of this bulletin is to review the literature about medical and surgical alternatives to hysterectomy and to offer treatment recommendations. Thu, 31 Jul 2008 09:00:00 EDT http://www.acog.org/publications/educational_bulletins/pb096.cfm resources@acog.org (ACOG Resource Center) ACOG Practice Bulletin In the United States, women of color (primarily African-American and Hispanic women) comprise most new cases of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) among women. Most women of color acquire the disease from heterosexual contact, often from a partner who has undisclosed risk factors for HIV infection. Safe-sex practices, especially consistent condom use, must be emphasized for all women, particularly for women of color. A combination of testing, education, and brief behavioral interventions can help reduce the rate of HIV infection and its complications among women of color. Thu, 31 Jul 2008 09:00:00 EDT http://www.acog.org/publications/committee_opinions/co414.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion Age is a significant factor influencing a woman's ability to conceive. Social trends have led to deferred childbearing, and an increasing number of women are experiencing age-related infertility and pregnancy loss. Women older than 35 years should receive expedited evaluation and treatment after 6 months of failed attempts to conceive, or earlier if clinically indicated. Thu, 31 Jul 2008 09:00:00 EDT http://www.acog.org/publications/committee_opinions/co413.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion Aromatase inhibitors appear to be effective as an adjuvant treatment for early-stage and late-stage breast cancer. Their role in chemoprevention of breast cancer in high-risk patients remains to be defined. Side effects of aromatase inhibitors in postmenopausal women are due to estrogen-lowering action at the target tissues and include hot flushes, vaginal dryness, arthralgias, and decreased bone mineral density. In reproductive-aged women, aromatase inhibitors stimulate gonadotropin secretion and increase ovarian follicular activity. The role of aromatase inhibitors in the treatment of endometriosis and in ovulation induction is still being investigated. Thu, 31 Jul 2008 09:00:00 EDT http://www.acog.org/publications/committee_opinions/co412.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion The American College of Obstetricians and Gynecologists recommends routine human immunodeficiency virus (HIV) screening for women aged 19-64 years and targeted screening for women with risk factors outside of that age range. Ideally, opt-out HIV screening should be performed, in which the patient is notified that HIV testing will be performed as a routine part of gynecologic and obstetric care, unless the patient declines testing (1). The American College of Obstetricians and Gynecologists recommends that obstetrician-gynecologists annually review patients' risk factors for HIV and assess the need for retesting. Thu, 31 Jul 2008 09:00:00 EDT http://www.acog.org/publications/committee_opinions/co411.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion Monthly newsletter for ACOG members. Thu, 31 Jul 2008 09:00:00 EDT http://www.acog.org/publications/acog_newsletters/acogToday0808.pdf resources@acog.org (ACOG Resource Center) ACOG Today Newsletter Los metodos de barrera son algunas de las formas anticonceptivas (control de natalidad) mas antiguas y seguras. Estos metodos funcionan actuando como barrera para impedir que el semen del hombre alcance el huevo de la mujer. Algunos metodos tambien pueden ofrecer proteccion contra ciertas enfermedades de transmision sexual (STDs por sus siglas en ingles). Este folleto explica: Los tipos de metodos de barrera; Como funcionan, y; Cuan bien evitan el embarazo. Thu, 24 Jul 2008 12:15:00 EDT http://www.acog.org/publications/patient_education/sp022.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet El uso de sustancias nocivas durante el embarazo puede causar problemas para usted y para su bebe. En algunos casos, como en los de tabaco y alcohol y consumo de drogas, puede sentir que no es capaz de dejar de usar estas sustancias. Pero existen formas para ayudarla a dejarlas. Este folleto explicara: Como las sustancias nocivas pueden afectar al feto; Como su uso puede afectarla a usted, y; Como obtener ayuda. Tue, 15 Jul 2008 12:20:00 EDT http://www.acog.org/publications/patient_education/sp170.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Muchas mujeres no se sienten comodas hablando sobre problemas de control intestinal. Podrian pensar que no hay nada que las pueda ayudar. Si usted habla con su medico sobre esto, el o ella podra ofrecerle tratamientos efectivos. Este folleto explicara: Las causas de los problemas de control intestinal; Como se diagnostican, y; Como puede volver a tener control sobre sus intestinos. Tue, 01 Jul 2008 16:30:00 EDT http://www.acog.org/publications/patient_education/sp139.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Monthly newsletter for ACOG members. Tue, 01 Jul 2008 10:30:00 EDT http://www.acog.org/publications/acog_newsletters/acogToday0708.pdf resources@acog.org (ACOG Resource Center) ACOG Today Newsletter Barrier methods are some of the oldest and safest forms of contraception (birth control). These methods work by acting as barriers to keep the man's sperm from reaching the woman's egg. Some methods also may protect against certain sexually transmitted diseases (STDs). This pamphlet explains: The types of barrier methods; How they work, and; How well they prevent pregnancy. Tue, 01 Jul 2008 10:00:00 EDT http://www.acog.org/publications/patient_education/bp022.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Sexually transmitted diseases (STDs) are infections that are spread by sexual contact. Except for colds and flu, STDs are the most common contagious (easily spread) diseases in the United States, with millions of new cases of STDs each year. Although some STDs can be treated and cured, others cannot. Prevention is the key to fighting STDs. By knowing the facts, you can take steps to protect your health. This pamphlet will explain: Types and symptoms of STDs; Risks of getting an STD, and; How to prevent STDs. Tue, 01 Jul 2008 10:00:00 EDT http://www.acog.org/publications/patient_education/bp009.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Anemia, the most common hematologic abnormality, is a reduction in the concentration of erythrocytes or hemoglobin in blood. The two most common causes of anemia in pregnancy and the puerperium are iron deficiency and acute blood loss. Iron requirements increase during pregnancy, and a failure to maintain sufficient levels of iron may result in adverse maternal-fetal consequences. The purpose of this document is to provide a brief overview of the causes of anemia in pregnancy, review iron requirements, and provide recommendations for screening and clinical management of anemia during pregnancy. Mon, 30 Jun 2008 08:20:00 EDT http://www.acog.org/publications/educational_bulletins/pb095.cfm resources@acog.org (ACOG Resource Center) ACOG Practice Bulletin This newsletter, published 6 times per year, offers synopses of the latest developments in obstetrics, gynecology, oncology, and infertility. Provides a review article on a controversial issue, an historical perspectives, and the yearly review of the ABOG Annual Board Certification examination. Mon, 30 Jun 2008 08:20:00 EDT http://www.acog.org/publications/clinical_review/clinicalReviewv13i4.pdf resources@acog.org (ACOG Resource Center) ACOG Clinical Review La depresion es una enfermedad comun que puede afectar a cualquier persona: ninos, adolescentes y adultos. Uno de cada 20 estadounidenses--mas de 17 millones de personas--sufre de depresion cada ano. Las mujeres tienen dos veces mas probabilidades de sufrir depresion que los hombres. La depresion es un problema medico que puede tratarse. Este folleto explica: Los sintomas de la depresion; Como se diagnostica, y; Como puede tratarse Fri, 27 Jun 2008 13:30:00 EDT http://www.acog.org/publications/patient_education/sp106.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Tomar buenas decisiones en lo que respecta a su estilo de vida es lo mejor que puede hacer para mantenerse sana. Las decisiones que tome pueden ayudarla a sentirse mejor ahora y prevenir problemas medicos en el futuro. Thu, 19 Jun 2008 11:30:00 EDT http://www.acog.org/publications/patient_education/sb006.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet A balanced diet is a basic part of good health at all times in your life. During pregnancy, your diet is even more important. The foods you eat are the main source of nutrients for your baby. As your baby grows, you will need more of most nutrients. This pamphlet will help you learn more about: Good food choices for you and your baby; Nutrients you will need, and; Healthy weight gain. Mon, 02 Jun 2008 10:05:00 EDT http://www.acog.org/publications/patient_education/bp001.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Using harmful substances during pregnancy can cause problems for you and your baby. In some cases, such as tobacco, alcohol, and drug use, you may feel that you are not able to stop using these substances. But there are ways to help you quit. This pamphlet will explain: How harmful substances can affect your fetus; How using them can affect you, and; How to get help. Mon, 02 Jun 2008 10:05:00 EDT http://www.acog.org/publications/patient_education/bp170.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet In the United States, ectopic pregnancy accounts for 2% of all first-trimester pregnancies and 6% of all pregnancy-related deaths; it is the leading cause of maternal death in the first trimester (1). Early detection of ectopic pregnancy can lead to successful management without surgery. Methotrexate, a folic acid antagonist, can be used successfully to treat early, nonruptured ectopic pregnancy. The purpose of this document is to review the risks and benefits of the use of methotrexate in the management of ectopic pregnancy. Fri, 30 May 2008 08:40:00 EDT http://www.acog.org/publications/educational_bulletins/pb094.cfm resources@acog.org (ACOG Resource Center) ACOG Practice Bulletin Genetic testing is poised to play an increasing role in the practice of obstetrics and gynecology. To assure patients of the highest quality of care, physicians should become familiar with the currently available array of genetic tests and the tests' limitations. Clinicians should be able to identify patients within their practices who are candidates for genetic testing. Candidates will include patients who are pregnant or considering pregnancy and are at risk for giving birth to affected children as well as gynecology patients who, for example, may have or be predisposed to certain types of cancer. The purpose of this Committee Opinion is to review some of the ethical issues related to genetic testing and provide guidelines for the appropriate use of genetic tests by obstetrician-gynecologists. Expert consultation and referral are likely to be needed when obstetrician-gynecologists are confronted with these issues. Fri, 30 May 2008 08:40:00 EDT http://www.acog.org/publications/committee_opinions/co410.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion Marketing of genetic testing, although similar to direct-to-consumer advertising of prescription drugs, raises additional concerns and considerations. These include issues of limited knowledge among patients and health care providers of available genetic tests, difficulty in interpretation of genetic testing results, lack of federal oversight of companies offering genetic testing, and issues of privacy and confidentiality. Until all of these considerations are addressed, direct or home genetic testing should be discouraged because of the potential harm of a misinterpreted or inaccurate result. Fri, 30 May 2008 08:40:00 EDT http://www.acog.org/publications/committee_opinions/co409.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion Fellows of the American College of Obstetricians and Gynecologists may choose to limit the scope of their practices to gynecology. The College considers early pregnancy care (often up to 12-14 weeks of gestation) to be within the scope of gynecology and gynecologic practice. Liability insurers who provide coverage for "gynecology-only" practices should provide coverage for clinical practice activities that involve the management of early pregnancy and its complications. Fri, 30 May 2008 08:40:00 EDT http://www.acog.org/publications/committee_opinions/co408.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion La infeccion por el virus de la hepatitis B es un problema especial para las mujeres embarazadas. Una mujer embarazada no solo enfrenta los riesgos de la hepatitis para ella, sino que tambien podria transmitirle el virus a su bebe. Aproximadamente 1 de cada 500 a 1,000 mujeres embarazadas tiene hepatitis al dar a luz. Es posible que otras esten infectadas pero que no muestren ninguna senal. Este folleto le explicara: Como el virus de la hepatitis B puede afectar su embarazo; Como se realizan las pruebas, y; Como se puede prevenir el virus. Thu, 15 May 2008 13:00:00 EDT http://www.acog.org/publications/patient_education/sp093.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet This newsletter, published 6 times per year, offers synopses of the latest developments in obstetrics, gynecology, oncology, and infertility. Provides a review article on a controversial issue, an historical perspectives, and the yearly review of the ABOG Annual Board Certification examination. Thu, 01 May 2008 18:15:00 EDT http://www.acog.org/publications/clinical_review/clinicalReviewv13i3.pdf resources@acog.org (ACOG Resource Center) ACOG Clinical Review Depression is a common illness that can affect anyone--children, adolescents, and adults. About 1 in 20 Americans--more than 17 million people--suffers from depression every year. Women are twice as likely as men to get depression. Depression is a medical problem that can be treated. This pamphlet explains: Symptoms of depression; How it is diagnosed, and; How it can be treated. Wed, 30 Apr 2008 11:45:00 EDT http://www.acog.org/publications/patient_education/bp106.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Symptoms of vulvovaginal disorders are common, often chronic, and can significantly interfere with women's sexual function and sense of well-being. In the evaluation of women who report symptoms of vulvar disorders, the most common diagnoses are dermatologic conditions and vulvodynia (both generalized and localized forms) (1). The purpose of this document is to review diagnostic approaches and provide a structured framework for the management of vulvar disorders. Wed, 30 Apr 2008 09:45:00 EDT http://www.acog.org/publications/educational_bulletins/pb093.cfm resources@acog.org (ACOG Resource Center) ACOG Practice Bulletin Diagnosis of low bone mass or osteopenia, defined by measures of bone mineral density (BMD), has generated much confusion. Because BMD alone is not sufficient to describe risk of fracture, clinicians face challenges in interpreting BMD and clinical risk factors, counseling patients on absolute risk of fracture, and determining the need for pharmacologic intervention. For fracture risk assessment, the most valuable risk factors appear to be BMD, age, prior fracture history, and risk of falling. Until better models of fracture risk exist, postmenopausal women in their 50s with T scores in the osteopenia range and without risk factors may well benefit from counseling on calcium and vitamin D intake and risk factor reduction to delay the initiation of pharmacologic intervention. Wed, 30 Apr 2008 09:45:00 EDT http://www.acog.org/publications/committee_opinions/co407.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion Obstetrician-gynecologists should recognize that being a defendant in a medical professional liability lawsuit can be one of life's most stressful experiences. Coping with the stress of medical professional liability litigation is an ongoing, complex process in which physicians often must struggle to regain a sense of personal identity and professional mastery, as well as control of their clinical practices. Open communication with family members will assist in reducing emotional isolation and self-blame; however, legal and clinical aspects of a case must be kept confidential. Peer support and individual professional counseling can be of great benefit. Rapid intervention facilitates healthier coping strategies and can restore a sense of equilibrium and self-esteem during an unpredictable time. Wed, 30 Apr 2008 09:45:00 EDT http://www.acog.org/publications/committee_opinions/co406.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion As more young women are cured of cancer with chemotherapy and radiotherapy, which can be gonadotoxic, interest is growing in treatments that may preserve fertility. In vitro fertilization with cryopreservation of embryos is currently the best option for fertility preservation when treatment for cancer is anticipated. Ovarian tissue cryopreservation and oocyte cryopreservation are two options with the potential to preserve fertility. Although these methods are developing rapidly, their use as a means to have a child after cancer treatment must be considered investigational and offered only with appropriate informed consent in a research setting and under the auspices of an institutional review board. Wed, 30 Apr 2008 09:45:00 EDT http://www.acog.org/publications/committee_opinions/co405.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion Monthly newsletter for ACOG members. Wed, 30 Apr 2008 09:45:00 EDT http://www.acog.org/publications/acog_newsletters/acogToday0508.pdf resources@acog.org (ACOG Resource Center) ACOG Today Newsletter Bowel control problems affect at least 1 million people in the United States. Loss of normal control of the bowels is called fecal incontinence. This leads to leakage of solid or liquid stool (feces) or gas. Many women are not comfortable talking about bowel control problems. They may think that nothing can help them. If you talk with your doctor about it, he or she can offer effective treatments. This pamphlet will explain: The causes of bowel control problems; How they are diagnosed, and; How you can help regain control of your bowels. Mon, 28 Apr 2008 10:00:00 EDT http://www.acog.org/publications/patient_education/bp139.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Durante el embarazo cambia el cuerpo de la mujer de muchas maneras. Ademas del cambio de peso, uno de los cambios mas notorios ocurre en la piel, el cabello, el vello y las unas. Es posible que muchos de estos cambios causen ansiedad porque pueden afectar su aspecto. Sin embargo, la mayoria de ellos no son perjudiciales y a menudo desaparecen despues de dar a luz. Mon, 28 Apr 2008 09:45:00 EDT http://www.acog.org/publications/patient_education/sp169.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Casi la mitad de todos los embarazos en Estados Unidos no son planeados. La mayoria de las mujeres pueden quedar embarazadas desde los primeros anos de la adolescencia hasta que tengan entre 45 y 49 anos. Los anticonceptivos pueden ayudar a las parejas a posponer el nacimiento de un bebe hasta que sea el momento adecuado para ellas, si lo hubiera. Algunos tipos de anticonceptivos tambien protegen contra las enfermedades venereas. Actualmente hay muchas opciones de anticonceptivos para las mujeres y los hombres. Mon, 21 Apr 2008 16:15:00 EDT http://www.acog.org/publications/patient_education/sb020.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet You should see your doctor regularly for preventive health care. This can help find problems early or prevent health problems before they occur. Preventive health care includes exams and screening tests that look for problems even before you are sick. It also includes immunizations, which help to prevent some diseases. Fri, 04 Apr 2008 12:00:00 EDT http://www.acog.org/publications/patient_education/ab006.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Infection with hepatitis B virus is a special problem for pregnant women. Not only does a pregnant woman face the risks of hepatitis herself, she also can pass the virus to her baby. About 1 in every 500-1,000 pregnant women has hepatitis when she gives birth. More pregnant women may be infected but not show any signs. This pamphlet will explain: How the hepatitis B virus can affect your pregnancy; How testing is done, and; How the virus can be prevented Tue, 01 Apr 2008 12:15:00 EDT http://www.acog.org/publications/patient_education/bp093.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet It is estimated that more than 500,000 pregnancies in the United States each year involve women who have psychiatric illnesses that either predate or emerge during pregnancy, and an estimated one third of all pregnant women are exposed to a psychotropic medication at some point during pregnancy (1). The use of psychotropic medications is a cause of concern for physicians and their patients because of the potential teratogenic risk, the risk of perinatal syndromes or neonatal toxicity, and the risk for abnormal postnatal behavioral development. With the limited information available on the risks of the psychotropic medications, clinical management must incorporate an appraisal of the clinical consequences of offspring exposure, the potential effect of untreated maternal psychiatric illness, and the available alternative therapies. The purpose of this document is to present current evidence on the risks and benefits of treatment for certain psychiatric illnesses during pregnancy. Mon, 31 Mar 2008 09:00:00 EDT http://www.acog.org/publications/educational_bulletins/pb092.cfm resources@acog.org (ACOG Resource Center) ACOG Practice Bulletin Late-preterm infants (defined as infants born between 34 0/7 weeks and 36 6/7 weeks of gestation) often are mistakenly believed to be as physiologically and metabolically mature as term infants. However, compared with term infants, late-preterm infants are at higher risk than term infants of developing medical complications, resulting in higher rates of infant mortality, higher rates of morbidity before initial hospital discharge, and higher rates of hospital readmission in the first months of life. Preterm delivery should occur only when an accepted maternal or fetal indication for delivery exists. Collaborative counseling by both obstetric and neonatal clinicians about the outcomes of late-preterm births is warranted unless precluded by emergent conditions. Mon, 31 Mar 2008 09:00:00 EDT http://www.acog.org/publications/committee_opinions/co404.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion The purpose of this Committee Opinion is to discuss issues related to end-of-life care, including terms and definitions, ethical principles, legal constructs, physician-patient communication, and educational opportunities pertinent for specialists in obstetrics and gynecology. Assumptions about the objectives of care--which may be understood differently by the patient and her caregivers--inevitably shape perceptions about appropriate treatment. Because unarticulated commitments to certain goals may lead to misunderstanding and conflict, the goals of care should be identified through shared communication and decision making and should be reexamined periodically. A good opportunity to initiate the discussion of caregiving goals, including end-of-life care, is during well-patient care. Physicians must be careful not to impose their own conception of benefit or burden on a patient. End-of-life care is particularly challenging for pregnant women, whose autonomy is limited in many states. Many apparent conflicts will be averted by recognizing the shared interests of the woman and her fetus. When interests diverge, however, pregnant women's autonomous decisions should be respected. Mon, 31 Mar 2008 09:00:00 EDT http://www.acog.org/publications/committee_opinions/co403.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion Monthly newsletter for ACOG members. Mon, 31 Mar 2008 09:00:00 EDT http://www.acog.org/publications/acog_newsletters/acogToday0408.pdf resources@acog.org (ACOG Resource Center) ACOG Today Newsletter An estimated 11% of U.S. women report at least one physician-diagnosed urinary tract infection (UTI) per year, and the lifetime probability that a woman will have a UTI is 60% (1, 2). Despite the frequency of UTIs, there is confusion about diagnostic strategies, and changes in antimicrobial resistance among uropathogens require alterations in traditional treatment regimens. The purpose of this bulletin is to address the diagnosis, treatment, and prevention of uncomplicated acute bacterial cystitis and acute bacterial pyelonephritis in nonpregnant women. Complicated UTIs (eg, in patients with diabetes mellitus, abnormal anatomy, prior urologic surgery, a history of renal stones, an indwelling catheter, spinal cord injury, immunocompromise, or in pregnant patients) are a heterogeneous group of conditions beyond the scope of this bulletin. Fri, 29 Feb 2008 09:00:00 EST http://www.acog.org/publications/educational_bulletins/pb091.cfm resources@acog.org (ACOG Resource Center) ACOG Practice Bulletin A single course of corticosteroids is recommended for all pregnant women between 24 and 34 weeks of gestation who are at risk of preterm delivery within 7 days. A single course of antenatal corticosteroids should be administered to women with premature rupture of membranes (PROM) before 32 weeks of gestation to reduce the risks of respiratory distress syndrome, perinatal mortality, and other morbidities. The efficacy of corticosteroid use at 32-33 completed weeks of gestation for preterm PROM is unclear based on available evidence, but treatment may be beneficial, particularly if pulmonary immaturity is documented. No data exist on the efficacy of corticosteroid use before viability, and such use is not recommended at this time. Because of insufficient scientific evidence, repeat corticosteroid courses, including so-called "rescue therapy," should not be used routinely but should be reserved for women enrolled in clinical trials. Fri, 29 Feb 2008 09:00:00 EST http://www.acog.org/publications/committee_opinions/co402.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion Although physicians and their professional organizations have routinely accepted gifts from the health care industry, evidence now indicates that such gifts may misdirect physicians from their primary responsibility to act in the best interests of their patients. The American College of Obstetricians and Gynecologists' Committee on Ethics offers revised recommendations for relationships with industry. Physicians should understand the potential for influence when considering accepting gifts, including those of apparently nominal value. If any gifts are accepted, they should primarily entail benefit to patients or be related to the physician's work and should not be of substantial value. Sample drugs (or vouchers) may be dispensed but preferably as a full course of therapy on the basis of true need. Physicians are obligated to seek the most accurate, up-to-date, evidence-based, and balanced source of information about products. Neither patient referral nor industry support of institutions should be contingent on physician use or advocacy of a product. Physicians should disclose their financial interests to patients and colleagues. Support from industry for continuing medical education and professional meetings may be accepted, but subsidies should be disclosed and should not be accepted directly by physicians. Speakers may receive reasonable honoraria. Reimbursement for research should not exceed reasonable direct and indirect costs, and reasonable compensation for subsequent consulting and lecturing is permissible. Investigators who are or may become involved in a company's research may not buy or sell its stock until their involvement ends and the research is published or disseminated. Fri, 29 Feb 2008 09:00:00 EST http://www.acog.org/publications/committee_opinions/co401.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion The Institute of Medicine estimates that up to 7,000 individuals die each year as a result of medication errors. Despite the significant national attention medical errors are receiving, they continue to pervade the U.S. health care system. Medication-related errors consistently rank at the top of all medical errors, accounting for thousands of deaths annually in the United States. Many new technologies are available that, when integrated into the various medication-related processes, can significantly reduce the incidence of preventable medication errors. Practicing obstetrician-gynecologists should be familiar with these technologies and the evidence supporting their use. Fri, 29 Feb 2008 09:00:00 EST http://www.acog.org/publications/committee_opinions/co400.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion This newsletter, published 6 times per year, offers synopses of the latest developments in obstetrics, gynecology, oncology, and infertility. Provides a review article on a controversial issue, an historical perspectives, and the yearly review of the ABOG Annual Board Certification examination. Fri, 29 Feb 2008 09:00:00 EST http://www.acog.org/publications/clinical_review/clinicalReviewv13i2.pdf resources@acog.org (ACOG Resource Center) ACOG Clinical Review Monthly newsletter for ACOG members. Fri, 29 Feb 2008 09:00:00 EST http://www.acog.org/publications/acog_newsletters/acogToday0308.pdf resources@acog.org (ACOG Resource Center) ACOG Today Newsletter Asthma is a common, potentially serious medical condition that complicates approximately 4-8% of pregnancies (1, 2). In general, the prevalence of and morbidity from asthma are increasing, although asthma mortality rates have decreased in recent years. The purpose of this document is to review the best available evidence about the management of asthma during pregnancy. Thu, 31 Jan 2008 09:00:00 EST http://www.acog.org/publications/educational_bulletins/pb090.cfm resources@acog.org (ACOG Resource Center) ACOG Practice Bulletin Two types of banks have emerged for the collection and storage of umbilical cord blood--public banks and private banks. Public banks promote allogenic (related or unrelated) donation, analogous to the current collection of whole blood units in the United States. Private banks were initially developed to store stem cells from umbilical cord blood for autologous use (taken from an individual for subsequent use by the same individual) by a child if the child develops disease later in life. If a patient requests information on umbilical cord blood banking, balanced and accurate information regarding the advantages and disadvantages of public versus private banking should be provided. The remote chance of an autologous unit of umbilical cord blood being used for a child or a family member (approximately 1 in 2,700 individuals) should be disclosed. The collection should not alter routine practice for the timing of umbilical cord clamping. Physicians or other professionals who recruit pregnant women and their families for for-profit umbilical cord blood banking should disclose any financial interests or other potential conflicts of interest. Thu, 31 Jan 2008 09:00:00 EST http://www.acog.org/publications/committee_opinions/co399.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion It has long been recognized that fatigue can affect human cognitive and physical function. Although there are limited published data on the effects of fatigue on health care providers, including full-time practicing physicians, there is increasing awareness within the patient safety movement that fatigue, even partial sleep deprivation, impairs performance. Most of the current literature reviews resident function after recent work reform changes. However, the information available from many studies in health care and other occupations can be applied to the work habits of practicing obstetrician-gynecologists. Thu, 31 Jan 2008 09:00:00 EST http://www.acog.org/publications/committee_opinions/co398.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion Ethical responsibilities are described for obstetrician-gynecologists who choose to participate in surrogacy arrangements by 1) advising couples who are considering surrogacy, 2) counseling potential surrogate mothers, 3) providing obstetric services for pregnant women participating in surrogacy, or 4) offering assisted reproductive technologies related to surrogacy. Although the obligations of physicians will vary depending on the type and level of their involvement, in all cases physicians should carefully examine all relevant issues related to surrogacy, including medical, ethical, legal, and psychologic aspects. Thu, 31 Jan 2008 09:00:00 EST http://www.acog.org/publications/committee_opinions/co397.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion Mammography is an X-ray technique used to study the breasts. It can help doctors find breast cancer at an early stage (when treatment is more likely to succeed). About 1 in 8 women will get breast cancer during their lives. Most cases of breast cancer occur in women who are past menopause. By age 40 years, mammography should be a regular part of your health care. This is because the risk of breast cancer increases as a woman ages. This pamphlet will explain: How the test is done; What the test results mean, and; When you should have mammography. Thu, 31 Jan 2008 09:00:00 EST http://www.acog.org/publications/patient_education/bp076.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Pregnancy changes a woman's body in many ways. Besides the change in weight, some of the most noticeable changes are those to the skin, hair, and nails. Many of these changes can cause anxiety because they can affect the way you look. However, most of them are harmless and will often go away after you give birth. When you start to notice the changes to your skin or nails, talk with your doctor. Your doctor can discuss the best ways to treat the conditions. This pamphlet explains: Common skin, hair, and nail changes that may occur during pregnancy, and; What treatment, if any, will ease these changes. Thu, 31 Jan 2008 09:00:00 EST http://www.acog.org/publications/patient_education/bp169.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet Monthly newsletter for ACOG members. Thu, 31 Jan 2008 09:00:00 EST http://www.acog.org/publications/acog_newsletters/acogToday0208.pdf resources@acog.org (ACOG Resource Center) ACOG Today Newsletter Statements issued by the ACOG Executive Board. Thu, 31 Jan 2008 09:00:00 EST http://www.acog.org/publications/policy_statements/sop0802.cfm resources@acog.org (ACOG Resource Center) ACOG Statements of Policy In the United States, 600,000 hysterectomies are performed annually, of which one half include salpingo-oophorectomy (1). Salpingo-oophorectomy is performed electively at the time of hysterectomy to decrease the risk of ovarian cancer and to avoid possible morbidities and future surgery related to benign ovarian neoplasms, endometriosis, and pelvic pain. There is a subset of women with an elevated risk of ovarian carcinoma and breast carcinoma recurrence who are candidates for risk-reducing salpingo-oophorectomy performed for the primary purpose of reducing breast, ovarian, and fallopian tube carcinoma risks. The purpose of this document is to provide a framework for counseling women about the benefits and risks of elective salpingo-oophorectomy at the time of hysterectomy and to provide some guidelines for risk-reducing salpingo-oophorectomy. Mon, 31 Dec 2007 09:00:00 EST http://www.acog.org/publications/educational_bulletins/pb089.cfm resources@acog.org (ACOG Resource Center) ACOG Practice Bulletin Postoperative intravenous (IV) chemotherapy for advanced stage ovarian cancer has been the standard treatment. Recent studies have found significant survival advantages with the use of adjuvant intraperitoneal (IP) chemotherapy. Combination IV/IP chemotherapy may be an option for well counseled, carefully selected patients with optimally debulked stage III ovarian cancer. However, IV/IP treatment also has increased rates of pain, fatigue, and hematologic, gastrointestinal, metabolic, and neurologic toxicities. Given the balance of efficacy, quality of life, and toxicity, the decision to use IP chemotherapy must be individualized. Mon, 31 Dec 2007 09:00:00 EST http://www.acog.org/publications/committee_opinions/co396.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion Acknowledgment of the importance of patient autonomy and increased patient access to information has prompted more patient-generated requests for surgical interventions not necessarily recommended by their physicians. Decision making in obstetrics and gynecology should be guided by the ethical principles of respect for patient autonomy, beneficence, nonmaleficence, justice, and veracity. Each physician should exercise judgment when determining whether information presented to the patient is adequate. When working with a patient to make decisions about surgery, it is important for obstetricians and gynecologists to take a broad view of the consequences of surgical treatment and to acknowledge the lack of firm evidence for the benefit of one approach over another when evidence is limited. Mon, 31 Dec 2007 09:00:00 EST http://www.acog.org/publications/committee_opinions/co395.cfm resources@acog.org (ACOG Resource Center) ACOG Committee Opinion Genital herpes is a viral infection that can be spread through sexual contact. It affects one in five adults in the United States--about 45 million people. It is more common in women than in men. This pamphlet explains: Symptoms of genital herpes; How to reduce your risk of getting the virus, and; How to live with herpes and how to prevent infecting others. Mon, 31 Dec 2007 09:00:00 EST http://www.acog.org/publications/patient_education/bp054.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet El herpes genital es una infeccion causada por un virus que puede propagarse por contacto sexual y afecta a uno de cada cinco adultos en los Estados Unidos, o aproximadamente 45 millones de personas. Es mas comun en las mujeres que en los hombres. Este folleto explica: Los sintomas del herpes genital; Como reducir su riesgo de contraer el virus, y; Como vivir con el herpes y evitar infectar a otras personas. Mon, 31 Dec 2007 09:00:00 EST http://www.acog.org/publications/patient_education/sp054.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet The human immunodeficiency virus (HIV) causes acquired immunodeficiency syndrome (AIDS). Many people think AIDS is a disease that affects only homosexual (gay) men and intravenous (IV) drug users. This is not true. The rate of HIV infection is increasing most rapidly among heterosexual women. HIV infection is the fifth leading cause of death among women 19-39 years of age. This pamphlet explains: How to decrease your risk of getting or spreading HIV; How to find out if you are infected, and; How HIV can affect your pregnancy. Mon, 31 Dec 2007 09:00:00 EST http://www.acog.org/publications/patient_education/bp082.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet El virus de inmunodeficiencia humana (VIH) causa el sindrome de inmunodeficiencia adquirida (SIDA). Muchas personas piensan que el SIDA es una enfermedad que afecta unicamente a hombres homosexuales (gay) y drogadictos que usan drogas por via intravenosa (IV). Pero eso no es verdad. Actualmente la tasa de infeccion por el VIH aumenta con mas rapidez entre las mujeres heterosexuales. La infeccion por el VIH es la quinta causa principal de muerte entre las mujeres de 19 a 39 anos de edad. Este folleto explica: Como reducir su riesgo de contraer o transmitir el VIH; Como determinar si tiene la infeccion, y; Como el VIH puede afectar su embarazo. Mon, 31 Dec 2007 09:00:00 EST http://www.acog.org/publications/patient_education/sp082.cfm resources@acog.org (ACOG Resource Center) ACOG Patient Education Pamphlet This newsletter, published 6 times per year, offers synopses of the latest developments in obstetrics, gynecology, oncology, and infertility. Provides a review article on a controversial issue, an historical perspectives, and the yearly review of the ABOG Annual Board Certification examination. Mon, 31 Dec 2007 09:00:00 EST http://www.acog.org/publications/clinical_review/clinicalReviewv13i1.pdf resources@acog.org (ACOG Resource Center) ACOG Clinical Review Monthly newsletter for ACOG members. Mon, 31 Dec 2007 09:00:00 EST http://www.acog.org/publications/acog_newsletters/acogToday0108.pdf resources@acog.org (ACOG Resource Center) ACOG Today Newsletter