Practice Updates: Obesity in Adolescents, Early Detection of Epithelial Ovarian Cancer in Average-Risk Women, Hereditary Breast and Ovarian Cancer Syndrome


Stay up to date with ACOG's authoritative clinical guidance and helpful patient education materials. The following provides Practice Updates for August and September 2017. 

TOPIC SPOTLIGHT

Featured Committee Opinion: Obesity in Adolescents

A Committee Opinion from ACOG acknowledges the increasing rate of obesity among adolescents in the United States and recommends that ob-gyns be able to identify obese adolescents, particularly those at risk of comorbid conditions to identify possible opportunities to initiate behavioral counseling, participate in multidisciplinary teams that care for overweight and obese adolescents, and advocate for community programs to prevent obesity. ACOG also recommends that ob-gyns screen overweight and obese adolescents for depression, bullying, and peer victimization and appropriately refer to school-based and community-based resources as well as psychiatric services.

Ob-gyns should caution against the use of weight loss supplements. Oral emergency contraception should not be withheld from adolescents or women who are overweight or obese because no research to date has been powered adequately to evaluate a threshold weight at which it would be ineffective.

Committee Opinion 714: Obesity in Adolescents is available in the September 2017 issue of Obstetrics & Gynecology.

Featured Committee Opinion: The Role of the Obstetrician-Gynecologist in the Early Detection of Epithelial Ovarian Cancer in Women at Average Risk

Although the second most common type of female reproductive cancer, there is currently no strategy for early detection of ovarian cancer that reduces ovarian cancer mortality. ACOG recommends taking a detailed personal and family history for breast, gynecologic, and colon cancer to facilitate categorizing women based on their risk (average risk or high risk) of developing epithelial ovarian cancer. Epithelial ovarian cancer is most commonly detected in an advanced stage (65 percent of cases are stage III or stage IV) when the cure rate is only 18 percent. Early stage (localized) ovarian cancer is associated with improved survival.

ACOG guidance notes that the use of transvaginal ultrasonography and tumor markers (such as CA 125), alone or in combination, for the early detection of ovarian cancer in average-risk women have not been proved to reduce mortality, and harms exist from invasive diagnostic testing (eg, surgery) resulting from false-positive test results.

Committee Opinion 716: The Role of the Obstetrician-Gynecologist in the Early Detection of Epithelial Ovarian Cancer in Women at Average Risk is available in the September 2017 issue of Obstetrics & Gynecology.

Featured Committee Opinion: Opioid Use and Opioid Use Disorder in Pregnancy

Opioid agonist pharmacotherapy, also known as medication-assisted treatment (MAT), continues to be the recommended therapy for pregnant women with an opioid use disorder. In revised guidance, ACOG also recognizes that medically supervised withdrawal can be considered under the care of a physician experienced in perinatal addiction treatment and with informed consent if a woman does not accept MAT.

It is essential that screening be universal, since screening based only on factors such as poor adherence to prenatal care or prior adverse pregnancy outcome can result in missed cases and may add to stereotyping and stigma. ACOG recommends early universal screening, brief intervention (such as engaging the patient in a short conversation, providing feedback and advice), and referral for treatment of pregnant women with opioid use and opioid use disorder improve maternal and infant outcomes.

Committee Opinion 711: Opioid Use and Opioid Use Disorder in Pregnancy is available in the August 2017 issue of Obstetrics & Gynecology.

Featured Practice Bulletin: Hereditary Breast and Ovarian Cancer Syndrome

Ob–gyns play an important role in the identification and management of women with hereditary breast and ovarian cancer syndrome. Hereditary breast and ovarian cancer syndrome is an inherited cancer-susceptibility syndrome characterized by multiple family members with breast cancer, ovarian cancer, or both. Clinical genetic testing for gene mutations allows more precise identification of those women who are at an increased risk of inherited breast cancer and ovarian cancer. ACOG's Practice Bulletin focuses on the primary genetic mutations associated with hereditary breast and ovarian cancer syndrome, BRCA1 and BRCA2, and briefly discusses some of the other genes that have been implicated. 

Practice Bulletin 182: Hereditary Breast and Ovarian Cancer Syndrome is available in the September 2017 issue of Obstetrics & Gynecology

Zika Information

ACOG’s Zika webpage

ACOG Zika Practice Advisory

ACOG Zika Toolkit, including patient education video, infographic, and assessment web tool endorsed by CDC

CDC’s Pregnancy and Zika Testing Clinical Algorithm

CDC Zika Virus Website

State Health Department Contact list for ob-gyns (members only) for questions on CDC’s Zika Registry

State Health Department Contact list for ob-gyns (members only) for questions on testing

CDC Zika Pregnancy Hotline for Health Care Providers: Ob-gyns can contact the CDC Zika Pregnancy Hotline at 770-488-7100, or email ZikaPregnancy@cdc.gov for any concerns related to clinical management or the US Zika Pregnancy Registry

Office of Population Affairs' Zika Toolkit


LIST OF NEW PRACTICE PUBLICATIONS 2017

New Committee Opinions

See all Committee Opinions

                                                                                                                                  

New Practice Bulletins (members only)

See all Practice Bulletins

 

New Title: Clinical Updates in Women's Health Care (members only)

See all Clinical Updates Titles

 

New & Recently Updated Patient Education Pamphlets (members only)

See all Patient Education Pamphlets


Frequently Asked Questions (FAQs) for Patients

See all Frequently Asked Questions

American Congress of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188 | Mailing Address: PO Box 70620, Washington, DC 20024-9998