Obstetrics and gynecology
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To describe nationwide patterns in outpatient opioid dispensing after vaginal delivery. ⋯ Opioid dispensing after vaginal delivery is common and often occurs at high doses. Given the frequency of vaginal delivery, this may represent an important source of overprescription of opioids in the United States.
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Obstetrics and gynecology · Aug 2018
Zika Virus Infection Among Pregnant Women and Their Neonates in New York City, January 2016-June 2017.
To describe and compare differences in the epidemiologic, clinical, and laboratory characteristics of pregnant women with confirmed or probable Zika virus infection and to compare the risk of having a neonate with laboratory evidence of Zika virus infection with that of having a neonate without evidence of Zika virus infection by maternal characteristics. ⋯ In New York City, a greater proportion of women had probable Zika virus infection than confirmed infection. Women with some symptoms during pregnancy or periconceptionally were more likely to have a neonate with laboratory evidence of Zika virus infection. Neonates born to women with confirmed or probable Zika virus infection should be tested for Zika virus infection.
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Obstetrics and gynecology · Aug 2018
ACOG Committee Opinion No. 744: Value-Based Payments in Obstetrics and Gynecology.
Unsustainable health care costs combined with suboptimal patient outcomes have led health policy experts and payers to consider value-based payment or alternative payment models. Replacing fee-for-service reimbursement, these models link payment to value by rewarding efforts to enhance the quality of care at similar or reduced costs. Although many of the models employed to date have focused on primary care, management of chronic disease in the Medicare population, and episodes of care for common procedures, models for primary and specialty care of women are in the early stages of development. As specialists in women's health, obstetrician-gynecologists need to be actively engaged in this fundamental shift in the payment and delivery system.
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Obstetrics and gynecology · Aug 2018
Factors Influencing Young Women's Preparedness for Their First Pelvic Examination.
To understand factors contributing to women's level of preparedness for their first pelvic examination. ⋯ Preparedness for the first pelvic examination emerges as a subjective concept shaped and determined by the interplay of many factors. Although some factors such as age and personal sexual and reproductive health history may not be modifiable by clinical practice, other factors, including information that young women receive before experiencing their first pelvic examination, may be modifiable by clinical practice.
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Obstetrics and gynecology · Aug 2018
Effect of an Enhanced Recovery After Surgery Program on Opioid Use and Patient-Reported Outcomes.
To investigate the effect of an enhanced recovery after surgery (ERAS) program on perioperative outcomes with an emphasis on opioid consumption and patient-reported outcomes in the immediate and extended postoperative periods. ⋯ Implementation of an ERAS program was associated with significantly decreased opioid use after surgery and improvement in key patient-reported outcomes associated with functional recovery after surgery without compromising pain scores.