Obstetrics and gynecology
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Obstetrics and gynecology · Jan 2021
Practice GuidelineConsumer Testing for Disease Risk: ACOG Committee Opinion, Number 816.
With the increased emphasis on patient-driven health care and readily available access to patients as consumers through the internet and media, many genetic testing companies are marketing directly to consumers. Direct-to-consumer genetic testing may result in unique concerns and considerations, because of limited knowledge about available genetic tests among patients and health care professionals, challenges in interpretation of genetic test results, and lack of oversight of some companies, as well as issues of privacy and confidentiality. It is important to note that tests from different companies that evaluate the same condition or genes can vary greatly in scope and technical quality. ⋯ Because of these considerations and the fact that the interpretation of test results often requires specific training and medical knowledge, direct-to-consumer genetic testing ideally should be performed after counseling to review the test's potential benefits, risks, and limitations. Confirmatory genetic testing should be performed under the supervision of an appropriate obstetrician-gynecologist or other health care professional who is skilled in interpretation of genetic testing and risk assessment for the diseases of interest. This Committee Opinion has been updated to include information on counseling for patients who present with direct-to-consumer genetic test results, clinical vignettes, and an overview of currently available testing options as well as those potentially available in the near future.
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Obstetrics and gynecology · Jan 2021
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Antibodies at Delivery in Women, Partners, and Newborns.
To investigate the frequency of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies in parturient women, their partners, and their newborns and the association of such antibodies with obstetric and neonatal outcomes. ⋯ We found no association between SARS-CoV-2 infection and obstetric or neonatal complications. Sixty-seven percent of newborns delivered by mothers with antibodies had SARS-CoV-2 IgG antibodies. A limitation of our study is that we lacked statistical power to detect small but potentially meaningful differences between those with and without evidence of infection.
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Obstetrics and gynecology · Dec 2020
ReviewRethinking Prenatal Screening for Anomalies of Placental and Umbilical Cord Implantation.
The most common anomalies of implantation of the placenta and umbilical cord include placenta previa, placenta accreta spectrum, and vasa previa, and are associated with considerable perinatal and maternal morbidity and mortality. There is moderate quality evidence that prenatal diagnosis of these conditions improves perinatal outcomes and the performance of ultrasound imaging in diagnosing them is considered excellent. The epidemiology of placenta previa is well known, and it is standard clinical practice to assess placental location at the routine screening second-trimester detailed fetal anatomy ultrasound examination. ⋯ The sensitivity and specificity of ultrasonography for the diagnosis of these anomalies is also difficult to assess. Recent epidemiologic studies show an increase in the incidence of placental and umbilical cord implantation anomalies, which may be the result of increased use of assisted reproductive technology and cesarean delivery. There is good evidence to support targeted standardized protocols for women at high risk and that screening and diagnosing placenta accreta spectrum and vasa previa should be integrated into obstetric ultrasound training programs.
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Obstetrics and gynecology · Dec 2020
Universal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2) Testing Uptake in the Labor and Delivery Unit: Implications for Health Equity.
To understand severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing uptake in the labor and delivery unit and rationales for declining testing, and to institute a process to increase equitable testing uptake. ⋯ Universal SARS-CoV-2 testing uptake significantly increased through a rapid-cycle improvement initiative. Aligning hospital policy with patient-centered approaches led to nearly universally acceptable testing.
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Obstetrics and gynecology · Nov 2020
Randomized Controlled TrialAssociation of a Pediatric Gynecology eLearning Module With Resident Knowledge and Clinical Skills: A Randomized Controlled Trial.
To assess whether a pediatric and adolescent gynecology electronic learning (eLearning) module improves knowledge and clinical performance among obstetrics and gynecology residents. ⋯ Our pediatric and adolescent gynecology eLearning module resulted in improved short-term resident knowledge and simulated clinical skills among obstetrics and gynecology residents. Applying this learning technique in other programs may help address deficiencies in pediatric and adolescent gynecology education and training.