Obstetrics and gynecology clinics of North America
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Obstet. Gynecol. Clin. North Am. · Mar 2016
ReviewPelvic Organ Prolapse: New Concepts in Pelvic Floor Anatomy.
As the field of reconstructive pelvic surgery continues to evolve, with descriptions of new procedures to repair pelvic organ prolapse, it remains imperative to maintain a functional understanding of pelvic floor anatomy and support. The goal of this review was to provide a focused, conceptual approach to differentiating anatomic defects contributing to prolapse in the various compartments of the vagina. Rather than provide exhaustive descriptions of pelvic floor anatomy, basic pelvic floor anatomy is reviewed, new and historical concepts of pelvic floor support are discussed, and relevance to the surgical management of specific anatomic defects is addressed.
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Obstet. Gynecol. Clin. North Am. · Dec 2015
ReviewContraceptive Coverage and the Affordable Care Act.
A major goal of the Patient Protection and Affordable Care Act is reducing healthcare spending by shifting the focus of healthcare toward preventive care. Preventive services, including all FDA-approved contraception, must be provided to patients without cost-sharing under the ACA. No-cost contraception has been shown to increase uptake of highly effective birth control methods and reduce unintended pregnancy and abortion; however, some institutions and corporations argue that providing contraceptive coverage infringes on their religious beliefs. The contraceptive coverage mandate is evolving due to legal challenges, but it has already demonstrated success in reducing costs and improving access to contraception.
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Obstet. Gynecol. Clin. North Am. · Sep 2015
ReviewOrganizing an Effective Obstetric/Gynecologic Hospitalist Program.
The thoughtful development and implementation of a comprehensive obstetric/gynecologic (OB/GYN) hospitalist program can result in a cost-effective practice model that provides increased value through a wide variety of services. The continuous on-site availability of an OB/GYN specialist affords many benefits to patients, hospitals, and practicing physicians. A well-implemented and effective OB/GYN hospitalist program will be associated with many different service line improvements for hospitals. Such programs increase patient safety, promote risk reduction, and improve clinical outcomes, while enriching the quality of life of obstetricians and gynecologists.
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Obstet. Gynecol. Clin. North Am. · Sep 2015
ReviewThe Role of Obstetrics/Gynecology Hospitalists in Reducing Maternal Mortality.
The United States experienced a 6.1% annual increase in the maternal death rate from 2000 to 2013. Maternal deaths from hemorrhage and complications of preeclampsia are significant contributors to the maternal death rate. ⋯ By virtue of their continuous care of laboring patients, active involvement in hospital safety initiatives, and immediate availability, obstetric hospitalists are uniquely positioned to evaluate patients, initiate care, and coordinate a multidisciplinary effort. In cases of significant maternal hemorrhage, hypertensive crisis, and acute pulmonary edema, the availability of an obstetrics hospitalist may facilitate improved patient safety and fewer maternal deaths.
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Obstet. Gynecol. Clin. North Am. · Sep 2015
ReviewPotential Impact of Obstetrics and Gynecology Hospitalists on Safety of Obstetric Care.
Staffing models are critical aspects of care delivery. Provider staffing on the labor and delivery unit has recently received heightened attention. Based on the general medicine hospitalist model, the obstetrics and gynecology hospitalist or laborist model of obstetric care was introduced more than a decade ago as a plausible model-of-care delivery to improve provider satisfaction, with the goal of also improving safety and outcomes through continuous coverage by providers whose sole focus was on the labor and delivery unit without other competing clinical duties. It is plausible that this model of provider staffing and care delivery will increase safety.