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Committee Opinion Number 713, August 2017

(Replaces Committee Opinion No. 677, October 2016)

ABSTRACT: Corticosteroid administration before anticipated preterm birth is one of the most important antenatal therapies available to improve newborn outcomes. A single course of corticosteroids is recommended for pregnant women between 24 0/7 weeks and 33 6/7 weeks of gestation who are at risk of preterm delivery within 7 days, including for those with ruptured membranes and multiple gestations. It also may be considered for pregnant women starting at 23 0/7 weeks of gestation who are at risk of preterm delivery within 7 days, based on a family’s decision regarding resuscitation, irrespecti...


Committee Opinion Number 532, August 2012

(Reaffirmed 2016, Replaces No. 387, November 2007 and No. 322, November 2005)

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 692, April 2017

(Replaces Committee Opinion No. 623, February 2015)

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 712, August 2017

ABSTRACT: Intraamniotic infection, also known as chorioamnionitis, is an infection with resultant inflammation of any combination of the amniotic fluid, placenta, fetus, fetal membranes, or decidua. Intraamniotic infection is a common condition noted among preterm and term parturients. However, most cases of intraamniotic infection detected and managed by obstetrician–gynecologists or other obstetric care providers will be noted among term patients in labor. Intraamniotic infection can be associated with acute neonatal morbidity, including neonatal pneumonia, meningitis, sepsis, and death. Ma...


Committee Opinion Number 597, May 2014

(Reaffirmed 2016)

Abstract: Functional oxytocin deficiency and a faulty oxytocin signaling pathway have been observed in conjunction with autism spectrum disorder (ASD). Because exogenous synthetic oxytocin commonly is administered for labor induction and augmentation, some have hypothesized that synthetic oxytocin used for these purposes may alter fetal oxytocin receptors and predispose exposed offspring to ASD. However, current evidence does not identify a causal relationship between labor induction or augmentation in general, or oxytocin labor induction specifically, and autism or ASD. Recognizing the limit...


Committee Opinion Number 455, March 2010

(Reaffirmed 2016)

Abstract: Numerous large clinical studies have evaluated the evidence regarding magnesium sulfate, neuroprotection, and preterm births. The Committee on Obstetric Practice and the Society for Maternal-Fetal Medicine recognize that none of the individual studies found a benefit with regard to their primary outcome. However, the available evidence suggests that magnesium sulfate given before anticipated early preterm birth reduces the risk of cerebral palsy in surviving infants. Physicians electing to use magnesium sulfate for fetal neuroprotection should develop specific guidelines regarding i...


Committee Opinion Number 652, January 2016

(Reaffirmed 2016. Replaces Committee Opinion Number 573, September 2013)

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 485, April 2011

(Replaces No. 279, December 2002, Reaffirmed 2016)

ABSTRACT: In 2010, the Centers for Disease Control and Prevention revised its guidelines for the prevention of perinatal group B streptococcal disease. Although universal screening at 35–37 weeks of gestation and intrapartum antibiotic prophylaxis continue to be the basis of the prevention strategy, these new guidelines contain important changes for clinical practice. The Committee on Obstetric Practice endorses the new Centers for Disease Control and Prevention recommendations, and recognizes that even complete implementation of this complex strategy will not eliminate all cases of early-ons...


Committee Opinion Number 571, September 2013

(Reaffirmed 2015)

ABSTRACT: Currently, only povidone-iodine preparations are approved for vaginal surgical-site antisepsis. However, there are compelling reasons to consider chlorhexidine gluconate solutions for off-label use in surgical preparation of the vagina, especially in women with allergies to iodine. Although chlorhexidine gluconate solutions with high concentrations of alcohol are contraindicated for surgical preparation of the vagina, solutions with low concentrations of alcohol (eg, 4%) are both safe and effective for off-label use as vaginal surgical preparations and may be used as an alternative ...


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