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Practice Bulletin Number 128, July 2012

(Reaffirmed 2016)

Members Only


Committee Opinion Number 681, December 2016

(Replaces Committee Opinion No. 520, March 2012) (Reaffirmed 2019)

ABSTRACT: Adverse outcomes, preventable or otherwise, are a reality of medical care. Most importantly, adverse events affect patients, but they also affect health care practitioners. Disclosing information about adverse events has benefits for the patient and the physician and, ideally, strengthens the patient–physician relationship and promotes trust. Studies show that after an adverse outcome, patients expect and want timely and full disclosure of the event, an acknowledgment of responsibility, an understanding of what happened, expressions of sympathy, and a discussion of what is being don...


Committee Opinion Number 645, November 2015

(Reaffirmed 2018)

ABSTRACT: Gonorrhea is the second most commonly reported bacterial sexually transmitted disease in the United States, with an estimated 820,000 new Neisseria gonorrhoeae infections occurring each year. Antimicrobial resistance limits treatment success, heightens the risk of complications, and may facilitate the transmission of sexually transmitted infections. Neisseria gonorrhoeae has developed resistance to the sulfonamides, the tetracyclines, and penicillin. Dual therapy with ceftriaxone and azithromycin remains the only recommended first-line regimen for the treatment of gonorrhea in the U...


Committee Opinion Number 760, December 2018

ABSTRACT: Dysmenorrhea, or menstrual pain, is the most common menstrual symptom among adolescent girls and young women. Most adolescents experiencing dysmenorrhea have primary dysmenorrhea, defined as painful menstruation in the absence of pelvic pathology. When the patient’s history suggests primary dysmenorrhea, empiric treatment should be initiated. When a patient does not experience clinical improvement for her dysmenorrhea within 3–6 months of therapy initiation, her obstetrician–gynecologist should investigate for possible secondary causes and for treatment adherence. Secondary dysmenor...


85.
November 2018

Practice Bulletin Number 200, November 2018

(Replaces Practice Bulletin Number 150, May 2015)

Early pregnancy loss, or loss of an intrauterine pregnancy within the first trimester, is encountered commonly in clinical practice. Obstetricians and gynecologists should understand the use of various diagnostic tools to differentiate between viable and nonviable pregnancies and offer the full range of therapeutic options to patients, including expectant, medical, and surgical management. The purpose of this Practice Bulletin is to review diagnostic approaches and describe options for the management of early pregnancy loss.


Committee Opinion Number 587, February 2014

(Replaces Committee Opinion Number 492, May 2011) (Reaffirmed 2018)

ABSTRACT: Physicians’ ability to effectively and compassionately communicate information is key to a successful patient–physician relationship. The current health care environment demands increasing clinical productivity and affords less time with each patient, which can impede effective patient–physician communication. The use of patient-centered interviewing, caring communication skills, and shared decision making improves patient–physician communication. Involving advanced practice nurses or physician assistants may improve the patient’s experience and understanding of her visit. Electroni...


Committee Opinion Number 568, July 2013

(Reaffirmed 2019)

ABSTRACT: Elder abuse, a violation of human rights, is defined as a single or repeated act, or lack of appropriate actions, which causes harm, risk of harm, or distress to an individual 60 years or older. As many as 1 in 10 older adults have been victims of elder abuse. Most cases of abuse occur in women. The U.S. Census predicts that by 2030, the segment of the population that is older than 65 years will reach an estimated 72 million. Categories of elder abuse include physical, psychological, emotional, or sexual abuse; neglect; abandonment; and financial exploitation. Screening, education, ...


Committee Opinion Number 323, November 2005

(Replaces No. 164, December 1995) (Reaffirmed 2019)

ABSTRACT: Because of a lack of evidence from randomized trials, it remains unclear whether the benefits of routine elective coincidental appendectomy outweigh the cost and risk of morbidity associated with this prophylactic procedure. Because the risk–benefit analysis varies according to patient age and history, the decision to perform an elective coincidental appendectomy at the time of an unrelated gynecologic surgical procedure should be based on individual clinical scenarios and patient characteristics and preferences.


Committee Opinion Number 578, November 2013

(Reaffirmed 2016. Replaces No. 395, January 2008)

ABSTRACT: Acknowledgment of the importance of patient autonomy and increased patient access to information, such as information on the Internet, has prompted more patient-generated requests for surgical interventions not traditionally recommended. Depending on the context, acceding to a request for a surgical option that is not traditionally recommended can be ethical. Decisions about acceding to patient requests for nontraditional surgical interventions should be based on strong support for patients’ informed preferences and values; understood in the context of an interpretive conversation; ...


90.
September 2015

Practice Bulletin Number 152, September 2015

(Replaces Practice Bulletin Number 112, May 2010) (Reaffirmed 2018)

Emergency contraception, also known as postcoital contraception, is therapy used to prevent pregnancy after an unprotected or inadequately protected act of sexual intercourse. Common indications for emergency contraception include contraceptive failure (eg, condom breakage or missed doses of oral contraceptives) and failure to use any form of contraception (1–3). Although oral emergency contraception was first described in the medical literature in the 1960s, the U.S. Food and Drug Administration (FDA) approved the first dedicated product for emergency contraception in 1998. Since then, sever...


Committee Opinion Number 767, February 2019

(Replaces Committee Opinion Number 692, September 2017)

ABSTRACT: Acute-onset, severe systolic hypertension; severe diastolic hypertension; or both can occur during the prenatal, intrapartum, or postpartum periods. Pregnant women or women in the postpartum period with acute-onset, severe systolic hypertension; severe diastolic hypertension; or both require urgent antihypertensive therapy. Introducing standardized, evidence-based clinical guidelines for the management of patients with preeclampsia and eclampsia has been demonstrated to reduce the incidence of adverse maternal outcomes. Individuals and institutions should have mechanisms in place to...


Committee Opinion Number 480, March 2011

Reaffirmed 2017

ABSTRACT: Empathy is the process through which one attempts to project oneself into another's life and imagine a situation from his or her point of view. Most individuals do have an innate capacity to show empathy toward others. Empathy is as important to being a good physician as technical competence. However, at times the health care environment and educational process overly emphasize technological competence, curing disease rather than healing the patient, or the economic aspects of medicine. This may interfere with an empathic approach in the clinical setting. In this Committee Opinion, ...


Committee Opinion Number 733, April 2018

ABSTRACT: In the United States, it is common for women, including mothers and pregnant women, to work outside the home. Working during pregnancy is generally safe. For those in high-risk occupations or with medically complicated pregnancies, work accommodations often can allow for continued safe employment. The major employment issues concerning pregnant women include pregnancy-related discrimination, work accommodations that allow continued employment, job-protected leave, and wage replacement while on leave. Workplace discrimination related to being pregnant and pregnancy-related harassment...


94.
January 2015

Committee Opinion Number 617, January 2015

(Replaces Committee Opinion Number 403, April 2008) (Reaffirmed 2018)

ABSTRACT: Obstetrician–gynecologists care for women throughout their lifespans and are in an ideal position to have ongoing discussions with healthy patients about their values and wishes regarding future care and to encourage them to complete an advance directive for health care. In addition, situations may arise in which obstetrician–gynecologists need to participate in end-of-life care. When end-of-life decisions need to be made while a woman is pregnant, the level of ethical complexity often is increased. The purpose of this Committee Opinion is to discuss ethical issues related to end-of...


95.
May 2007

Practice Bulletin Number 81, May 2007

Reaffirmed 2018

Members Only


96.
April 2015

Practice Bulletin Number 149, April 2015

(Replaces Practice Bulletin Number 65, August 2005). Reaffirmed 2019

Members Only


Committee Opinion Number 631, May 2015

(Reaffirmed 2019)

ABSTRACT: Endometrial hyperplasia is of clinical significance because it is often a precursor lesion to adenocarcinoma of the endometrium. Making the distinction between hyperplasia and true precancerous lesions or true neoplasia has significant clinical effect because their differing cancer risks must be matched with an appropriate intervention to avoid undertreatment or overtreatment. Pathologic diagnosis of premalignant lesions should use criteria and terminology that clearly distinguish between clinicopathologic entities that are managed differently. At present, the endometrial intraepith...


Members Only


99.
December 2017

Members Only


Members Only


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