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Committee Opinion Number 776, April 2019

ABSTRACT: Because autoimmune conditions occur more often among women of childbearing age, continuation of these medications during pregnancy is often considered to optimize disease management in the woman and pregnancy outcomes, without placing the fetus at undue risk. Many commonly prescribed drugs can be used safely during pregnancy without risk of teratogenicity or pregnancy complications, whereas a few are strictly contraindicated. The decision to use any agent during pregnancy should be based on the clinical context, risks associated with individual medications, and gestational age. For ...


Committee Opinion Number 775, April 2019

(Replaces Committee Opinion No. 696, April 2017)

ABSTRACT: The American College of Obstetricians and Gynecologists' Committee on Obstetric Practice acknowledges that the issue of nonobstetric surgery during pregnancy is an important concern for physicians who care for women. Because of the difficulty of conducting large-scale randomized clinical trials in this population, there are no data to allow for specific recommendations. It is important for a physician to obtain an obstetric consultation before performing nonobstetric surgery and some invasive procedures (eg, cardiac catheterization or colonoscopy) because obstetricians are uniquely ...


Practice Bulletin Number 207, March 2019

(Replaces Practice Bulletin Number 166, September 2016)

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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...


Practice Bulletin Number 201, December 2018

(Replaces Practice Bulletin Number 60, March 2005)

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6.
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.


Practice Bulletin Number 199, September 2018

(Replaces Practice Bulletin Number 120, June 2011)

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Committee Opinion Number 743, July 2018

ABSTRACT: Low-dose aspirin has been used during pregnancy, most commonly to prevent or delay the onset of preeclampsia. The American College of Obstetricians and Gynecologists issued the Hypertension in Pregnancy Task Force Report recommending daily low-dose aspirin beginning in the late first trimester for women with a history of early-onset preeclampsia and preterm delivery at less than 34 0/7 weeks of gestation, or for women with more than one prior pregnancy complicated by preeclampsia. The U.S. Preventive Services Task Force published a similar guideline, although the list of indications...


Practice Bulletin Number 197, July 2018

(Replaces Practice Bulletin Number 138, September 2013)

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Committee Opinion Number 742, July 2018

ABSTRACT: Pain and fatigue are the most common problems reported by women in the early postpartum period. Pain can interfere with a woman’s ability to care for herself and her infant. Untreated pain is associated with a risk of greater opioid use, postpartum depression, and development of persistent pain. Nonpharmacologic and pharmacologic therapies are important components of postpartum pain management. Because 81% of women in the United States initiate breastfeeding during the postpartum period, it is important to consider the drug effects of all prescribed medications on the mother–infant ...


Practice Bulletin Number 196, July 2018

(Replaces Practice Bulletin Number 123, August 2011)

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12.
March 2018

Practice Bulletin Number 193, March 2018

(Replaces Practice Bulletin Number 191, February 2018)

Ectopic pregnancy is defined as a pregnancy that occurs outside of the uterine cavity. The most common site of ectopic pregnancy is the fallopian tube. Most cases of tubal ectopic pregnancy that are detected early can be treated successfully either with minimally invasive surgery or with medical management using methotrexate. However, tubal ectopic pregnancy in an unstable patient is a medical emergency that requires prompt surgical intervention. The purpose of this document is to review information on the current understanding of tubal ectopic pregnancy and to provide guidelines for timely d...


Practice Bulletin Number 192, March 2018

(Replaces Practice Bulletin Number 75, August 2006) (Reaffirmed 2019)

Members Only


14.
February 2018

Practice Bulletin Number 190, February 2018

(Replaces Practice Bulletin Number 180, July 2017) (Reaffirmed 2019)

Members Only


Practice Bulletin Number 189, January 2018

(Replaces Practice Bulletin 153, September 2015)

Members Only


16.
December 2017

Members Only


Members Only


18.
October 2017

Practice Bulletin Number 183, October 2017

(Replaces Practice Bulletin Number 76, October 2006) (Reaffirmed 2019)

Members Only


19.
September 2017

Members Only


Committee Opinion Number 717, September 2017

(Replaces Committee Opinion 494, June 2011) (Reaffirmed 2019)

ABSTRACT: The evidence regarding an association between the nitrofuran and sulfonamide classes of antibiotics and birth defects is mixed. As with all patients, antibiotics should be prescribed for pregnant women only for appropriate indications and for the shortest effective duration. During the second and third trimesters, sulfonamides and nitrofurantoins may continue to be used as first-line agents for the treatment and prevention of urinary tract infections and other infections caused by susceptible organisms. Prescribing sulfonamides or nitrofurantoin in the first trimester is still consi...


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