Obstetrics and gynecology
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To estimate the prevalence of filled opioid prescriptions after vaginal delivery. ⋯ More than 1 in 10 Medicaid-enrolled women fill an outpatient opioid prescription after vaginal delivery. National opioid-prescribing recommendations for common obstetrics procedures such as vaginal delivery are warranted.
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Obstetrics and gynecology · Mar 2017
Single Health System Adherence to 2012 Cervical Cancer Screening Guidelines at Extremes of Age and Posthysterectomy.
To estimate the proportion of guideline nonadherent Pap tests in women aged younger than 21 years and older than 65 years and posthysterectomy in a single large health system. Secondary objectives were to describe temporal trends and patient and health care provider characteristics associated with screening in these groups. ⋯ For women aged younger than 21 years and older than 65 years and posthysterectomy, 35% of Pap tests performed in our health system were not guideline-adherent. There were no patient or health care provider characteristics associated with guideline nonadherent screening across all groups.
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Obstetrics and gynecology · Mar 2017
Committee Opinion No.689 Summary: Delivery of a Newborn With Meconium-Stained Amniotic Fluid.
In 2006, the American Academy of Pediatrics and the American Heart Association published the 2005 guidelines on neonatal resuscitation. Before the 2005 guidelines, management of a newborn with meconium-stained amniotic fluid included suctioning of the oropharynx and nasopharynx on the perineum after the delivery of the head but before the delivery of the shoulders. The 2005 guidelines did not support this practice because routine intrapartum suctioning does not prevent or alter the course of meconium aspiration syndrome in vigorous newborns. ⋯ Infants with meconium-stained amniotic fluid should no longer routinely receive intrapartum suctioning, whether they are vigorous or not. In addition, meconium-stained amniotic fluid is a condition that requires the notification and availability of an appropriately credentialed team with full resuscitation skills, including endotracheal intubation. Resuscitation should follow the same principles for infants with meconium-stained fluid as for those with clear fluid.
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Obstetrics and gynecology · Feb 2017
Randomized Controlled TrialTranscutaneous Nerve Stimulation for Pain Relief During Office Hysteroscopy: A Randomized Controlled Trial.
To evaluate the pain-relieving effect of transcutaneous electrical nerve stimulation (TENS) during office-based hysteroscopy without sedation. ⋯ ClinicalTrials.gov, www.clinicaltrials.gov, NCT02647008.
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Obstetrics and gynecology · Feb 2017
Randomized Controlled TrialEnhanced Recovery Program and Length of Stay After Laparotomy on a Gynecologic Oncology Service: A Randomized Controlled Trial.
To estimate whether a rapid recovery program would reduce length of stay among patients undergoing laparotomy on a gynecologic oncology service. ⋯ ClinicalTrials.gov, https://clinicaltrials.gov, NCT01705288.