News and Recommendations
ACOG recommends that all health care providers and patients follow the health and travel advisory released by the U.S. Centers for Disease Control and Prevention (CDC) about the Zika virus and its potential impact on pregnant women and their fetuses. Travel to regions with ongoing Zika virus outbreaks is not recommended for women who are pregnant or women who are considering pregnancy. For more information, see https://www.acog.org/About-ACOG/News-Room/Statements/2016/ACOG-Statement-on-Zika-Virus and http://www.cdc.gov/zika.
Antenatal Carrier Screening for Genetic Conditions
The American College of Obstetricians and Gynecologists (ACOG) recommends that genetic carrier screening be provided to evey pregnant woman. See Genetic Carrier Testing under Pregnancy Care for more information. In March 2017, ACOG recommended that Cystic Fibrosis and Spinal Muscular Atrophy carrier screening be offered to all pregnant women.
The CDC (Centers for Disease Control) recommends the flu vaccine for pregnant women. The flu vaccine is the best protection against flu and is safe for pregnant women. For more information, see http://www.cdc.gov/flu/protect/vaccine/pregnant.htm.
TDaP (Tetanus, Diphtheria and Pertussis) vaccine:
The CDC (Centers for Disease Control) recommends the TDaP vaccine during each pregnancy, with optimal timing between 27 and 36 weeks of gestation, although the TDaP vaccine may be given at any time during pregnancy. "Cocooning," or giving the TDaP to adolescents and adults who have close contact with an infant < 12 months, is also recommended. For more information, see http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6207a4.htm.
HPV (Gardasil) Vaccine:
The CDC (Centers for Disease Control) and ACOG (American Congress of Obstetricians and Gynecologists (ACOG) recommend the HPV (human papillomavirus) vaccine to be administerted to females between 9 and 26 years of age, with a target age of 11-12 years of age. The vaccine is not recommended during pregnancy. Lactating women can receive the vaccine. Ongoing cervical cytology screening (Pap smears) should still be emphasized for all women ages 21 years and older.
The American Congress of Obstetricians and Gynecologists (ACOG), The American Cancer Society (ACS) and U.S. Preventive Services Task Force (USPSTF) differ in mammogram guidelines. On July 20, 2011, ACOG released a recommendation to offer mammograms annually to women beginning at age 40. Our current practice coincides with ACOG recommendations. This recommendation persists despite the 2015 ACS guideline revision. The ACS recommends offering annualscreening mammograms to women ages 45-54, and screening mammograms every 2 years after age 55. Women ages 40-44 should have the choice to start annual screening mammograms. The USPSTF recommends screening mammograms every 2 years beginning at age 50 for women at average risk for breast cancer.
Hormone Therapy (HT):
In 2012, the North American Menopause Society (NAMS) released a new Position Statement on hormone therapy. (1) Hormone therapy remains the most effective treatment available for menopausal symptoms, including hot flashes and night sweats. Many women can take it safely. (2) If you have had blood clot, heart disease, stroke, or breast cancer, it may not be in your best interest to take HT. (3) How long you should take HT is different for EPT (estrogen-progesterone therapy) and ET (estrogen-only therapy). For EPT, the time is limited by the increased risk of breast cancer that is seen with more than 3 to 5 years of use. For ET, no sign of an increased risk of breast cancer was seen during an average of 7 years of treatment. (4) Most healthy women below age 60 will have no increase in risk of heart disease with HT. The risks of stroke and blood clots in the lungs are increased, but in these younger age groups, the risks are less than 1 in every 1000 women per year taking HT. (5) ET delivered through the skin and low-dose oral estrogen may have lower risks of blood clots and stroke than standard doses of oral estrogen, but all the evidence is not yet available.
For more information on menopause on the NAMS website, see http://www.menopause.org/psht12patient.pdf.
For more information on menopause on the ACOG website, see http://pause.acog.org.