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Committee Opinion Number 532, August 2012

(Replaces No. 387, November 2007 and No. 322, November 2005) (Reaffirmed 2018)

ABSTRACT: Although improvement in long-term health is no longer an indication for menopausal hormone therapy, evidence supporting fewer adverse events in younger women, combined with its high overall effectiveness, has reinforced its usefulness for short-term treatment of menopausal symptoms. Menopausal therapy has been provided not only by commercially available products but also by compounding, or creation of an individualized preparation in response to a health care provider’s prescription to create a medication tailored to the specialized needs of an individual patient. The Women’s Health...


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 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 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...


Committee Opinion Number 652, January 2016

(Replaces Committee Opinion Number 573, September 2013) (Reaffirmed 2018)

ABSTRACT: The U.S. Food and Drug Administration advises against the use of magnesium sulfate injections for more than 5–7 days to stop preterm labor in pregnant women. Based on this, the drug classification was changed from Category A to Category D, and the labeling was changed to include this new warning information. However, the U.S. Food and Drug Administration’s change in classification addresses an unindicated and nonstandard use of magnesium sulfate in obstetric care. The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine continue to support ...


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 ...


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 ...


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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