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81. Newborn Screening

of collection, midwives must deliver spotted card(s) to their privileged / primary hospital site, either the outpatient lab or a postpartum ward, or if available a designated transport hub, to ensure efficient intra-hospital shipment of the card(s) to the NBS Laboratory. Spotted cards cannot be sent via Canada Post. 4. Babies born at home under the care of a midwife a. Recommended Practice: i. Midwives collect the blood spot card between 24 – 48 hours of age at home or in the community as required (...) prior to transport of the card(s) to the NBS Laboratory located at BC Children’s Hospital, Vancouver. Within 24 hours of collection, midwives must deliver spotted card(s) to their privileged / primary hospital site, either the outpatient lab or a postpartum ward, or if available a designated transport hub, to ensure efficient intra-hospital shipment of the card(s) to the NBS Laboratory. Spotted cards cannot be sent via Canada Post. 3. Blood Spot Card Collection, cont’d.10 Perinatal Services BC 5

2018 British Columbia Perinatal Health Program

82. Diagnosis and Treatment of Non-Neurogenic Overactive Bladder (OAB) in Adults

required to obtain treatments that may be costly and may present logistical challenges (e.g., therapies that require frequent visits to a physician's office). The negative impact of OAB symptoms on psychosocial functioning and QOL also has been well-documented. 19-22 Carrying out the activities of daily life and engaging in social and occupational activities can be profoundly affected by lack of bladder control and incontinence. Urinary incontinence in particular may have severe psychological

2019 American Urological Association

83. Assessment and Management of Patients at Risk for Suicide

With support from: The Office of Quality, Safety and Value, VA, Washington, DC & Office of Evidence Based Practice, U.S. Army Medical Command Version 2.0 – 2019 Based on evidence reviewed through April 2018 VA/DoD Clinical Practice Guideline for the Assessment and Management of Patients at Risk for Suicide May 2019 Page 3 of 142 Table of Contents I. Introduction 6 II. Background 7 A. Epidemiology and Impact in the General Population 7 B. Suicide in the Department of Defense and the Department of Veterans (...) of the evidence. The amount of new scientific evidence that had accumulated since the previous version of the CPG was also taken into consideration in the identification of the KQs. In addition, the Champions assisted in: • Identifying appropriate disciplines of individuals to be included as part of the Work Group • Directing and coordinating the Work Group • Participating throughout the guideline development and review processes The VA Office of Quality, Safety and Value, in collaboration with the Office

2019 VA/DoD Clinical Practice Guidelines

84. Stillbirth care

to copy and communicate the work in its current form for non-commercial purposes, as long as you attribute Queensland Clinical Guidelines, Queensland Health and abide by the licence terms. You may not alter or adapt the work in any way. To view a copy of this licence, visit For further information, contact Queensland Clinical Guidelines, RBWH Post Office, Herston Qld 4029, email, phone (07) 3131 6777 (...) . For permissions beyond the scope of this licence, contact: Intellectual Property Officer, Queensland Health, GPO Box 48, Brisbane Qld 4001, email, phone (07) 3234 1479. Queensland Clinical Guideline: Stillbirth care Refer to online version, destroy printed copies after use Page 3 of 34 Flow Chart: Stillbirth care Abbreviations: CTG: Cardiotocograph; FGR: fetal growth restriction; GP: General Practitioner; PPM: Private Practice Midwife; PSANZ: Perinatal Society of Australia and New

2019 Queensland Health

85. Recommendations for Prevention and Control of Influenza in Children, 2019–2020

of outpatient clinic and emergency department visits for influenzalike illness, high influenza-related hospitalization rates, and high numbers of deaths. – Influenza A(H3N2) viruses predominated through February 2018; influenza B viruses predominated from March 2018 onward. Although hospitalization rates for children that season did not exceed those reported during the 2009 pandemic, they did surpass rates reported in previous high-severity A(H3N2)-predominant seasons. Excluding the 2009 pandemic, the 186 (...) of gestation and postpartum. Any licensed, recommended, and age-appropriate influenza vaccine may be used, although experience with the use of RIV4 in pregnant women is limited. LAIV is contraindicated during pregnancy. Data on the safety of influenza vaccination at any time during pregnancy continues to accumulate and support the safety of influenza immunization during pregnancy. In a 5-year retrospective cohort study from 2003 to 2008 with more than 10 000 women, influenza vaccination in the first

2019 American Academy of Pediatrics

86. Access to Hormonal Contraception

potential obstacles including lack of time, reimbursement issues, and possible resistance from physicians (9). Additionally, online access, which is permitted in some areas in the United States, allows a woman to bypass the office visit and obtain a pre- scription for some types of hormonal contraception by answering a series of online questions or by talking to a clinician through telemedicine (eg, video or online call) (10). The contraceptives then are delivered to the individual’s home. Although (...) that women want over-the- counter access to hormonal contraception because it is easier to obtain. c Data support that progestin-only hormonal meth- ods are generally safe and carry no or minimal risk of venous thromboembolism (VTE). c The VTE risk with combined oral contraceptive use is small compared with the increased risk of VTE during pregnancy and the postpartum period. c Pelvic and breast examinations, cervical cancer screening, and sexually transmitted infection screen- ing are not required

2019 American College of Obstetricians and Gynecologists

87. Updated clinical practice guidelines on pregnancy care

C at the first antenatal visit; recommend against routine testing for vitamin D status in the absence of a specific indication; recommend discussing weight change, diet and physical activity with all pregnant women; and recommend offering pregnant women the opportunity to be weighed at every antenatal visit and encouraging women to self-monitor weight gain. Changes in management as a result of the guidelines: The guidelines will enable pregnant women diagnosed with hepatitis C to be identified (...) and thus avoid invasive procedures that increase the risk of mother-to-baby transmission. Women can be treated postpartum, reducing the risk of liver disease and removing the risk of perinatal infection for subsequent pregnancies. Routine testing of all pregnant women for vitamin D status and subsequent vitamin D supplementation is not supported by evidence and should cease as the benefits and harms of vitamin D supplementation remain unclear. The recommendation for health professionals to provide

2018 MJA Clinical Guidelines

88. Intrapartum fetal surveillance

. In essence, you are free to copy and communicate the work in its current form for non-commercial purposes, as long as you attribute Queensland Clinical Guidelines, Queensland Health and abide by the licence terms. You may not alter or adapt the work in any way. To view a copy of this licence, visit For further information contact Queensland Clinical Guidelines, RBWH Post Office, Herston Qld 4029, email, phone (07 (...) ) 3131 6777. For permissions beyond the scope of this licence contact: Intellectual Property Officer, Queensland Health, GPO Box 48, Brisbane Qld 4001, email, phone (07) 3234 1479. Queensland Clinical Guideline: Intrapartum fetal surveillance Refer to online version, destroy printed copies after use Page 3 of 30 Flow Chart: Mode of fetal heart rate monitoring Abbreviations: APH Antepartum Haemorrhage; BMI Body Mass Index; CTG Cardiotocograph; FBS Fetal blood sample; FGR

2019 Queensland Health

89. Treatment of Drug-Resistant Tuberculosis

have yet to be developed. 4. Treatment response should be monitored clinically, radiographically, and bacteriologically, with cultures obtained at least monthly for pulmonary TB. When cultures remain positive after 3 months of treatment, susceptibility tests for drugs should be repeated. Weight and other measures of clinical response should be recorded monthly. 5. Patients should be educated and asked about adverse effects at each visit. Adverse effects should be investigated and ameliorated. 6 (...) and systemic symptoms and increase in weight), radiographically, and bacteriologically ( – ). If sputum cultures remain positive after 3 months of treatment, or if there is bacteriological reversion from negative to positive at any time, DST should be repeated ( ). Patients should be asked about the clinical response at each visit and weight recorded monthly. Monthly cultures help to identify early evidence of failure ( ). Most persons have difficulty taking one or more of the drugs used to treat MDR-TB

2019 Infectious Diseases Society of America

90. Practice Advisory: Management of Pregnant and Reproductive-Aged Women during a Measles Outbreak

manner, and measles exposure is suspected in a non-immune pregnant woman, the patient should receive measles immunoglobulin (IGIV). While most women have immunity to measles due to prior MMR vaccination, given risks associated with measles in pregnancy, possible infection or exposure to measles should be carefully and expediently investigated 2 . Obstetrician-gynecologists should follow local health department guidance for testing (see algorithm in reference 7 ). Postpartum MMR vaccine should (...) be administered postpartum* to women who lack evidence of measles immunity. Breastfeeding has not been shown to affect the immune response to MMR. MMR vaccine is safe in breastfeeding women and has not been shown to have adverse effects in neonates 8,9 Addressing vaccination with your patients Parental choice to opt-out of infant and childhood vaccination allows population immunity to drop below the threshold levels needed to stop outbreaks of measles, placing vulnerable patients such as pregnant women

2019 American College of Obstetricians and Gynecologists

91. Child Abuse, Elder Abuse, and Intimate Partner Violence

of reporting. Some injured children are unable to provide a history due to age, development, and/or fear. In a multivariate analysis of the stated reason for the visit, one of the best predictors of child physical abuse was injury inconsistent with the history, such as a vague or minor explanation for a significant injury (e.g., bumped head on car seat when a large hematoma is seen). Another good predictor is the patient was referred to the clinician for suspected child abuse. 6 Other overall impressions

2019 American College of Surgeons

92. Canadian immunization guide chapter on influenza and statement on seasonal influenza vaccine for 2017-2018

Association for Immunization Research and Evaluation), Dr. A. Cohn (Centre for Disease Control and Prevention), Ms. T. Cole (Canadian Immunization Committee), Dr. J. Emili (College of Family Physicians of Canada), Dr. M. Lavoie (Council of Chief Medical Officers of Health), Dr. C. Mah (Canadian Public Health Association), Dr. D. Moore (Canadian Paediatric Society), Dr. A. Pham-Huy (Association of Medical Microbiology and Infectious Disease Canada). Ex-Officio Representatives: Ms. G. Charos (Centre (...) attended acute respiratory illness. J Infect Dis. 2016;213(8):1216-23. (17) Louie JK, Acosta M, Jamieson DJ, et al. Severe 2009 H1N1 influenza in pregnant and postpartum women in California. N Engl J Med. 2010;362(1):27-35. (18) Siston AM, Rasmussen SA, Honein MA, et al. Pandemic 2009 influenza A(H1N1) virus illness among pregnant women in the United States. JAMA. 2010;303(15):1517-25. (19) Mak TK, Mangtani P, Leese J, et al. Influenza vaccination in pregnancy: current evidence and selected national

2017 CPG Infobase

93. Public health guidance on antenatal screening for HIV, hepatitis B, syphilis and rubella susceptibility in the EU/EEA ? addressing the vulnerable populations

the target levels of = 95% for antenatal testing coverage and antenatal care (defined as at least one visit) [16]. In the EU/EEA, the percentage of women tested at least once during pregnancy was estimated as 95% or higher in 12/18 countries for HIV and in 14/18 countries for syphilis [1]. While global efforts for the elimination of MTCT of hepatitis B and congenital rubella syndrome do not clearly specify targets for antenatal screening testing, data on testing coverage exist for a fraction of EU/EEA

2017 European Centre for Disease Prevention and Control - Public Health Guidance

94. Depression: Adult and Adolescent

are critical and contribute to the likelihood of good follow-through on treatment. Patient education should include: • The cause, symptoms and natural history of major depression • Shared decision making about treatment options • Information on what to expect during treatment • Follow-up (office visits, e-mail, and/or telephone) In addition to patient education, supportive care includes emotional support and guidance. Providers can engage in behavioral activation by encouraging patients to consider (...) tapering in two to three steps over a period of 2–3 months may reduce the risk of relapse and allows for improved awareness before any symptoms of relapse become severe. • For patients who have been on treatment for prolonged periods, have recurrent depression, or have a history of hospitalization or suicide attempts, consider tapering more slowly, over a period of 4–6 months. • Follow-up visits: Schedule at least one phone contact or office visit during tapering of medications, and another one 2–3

2017 Kaiser Permanente Clinical Guidelines

95. Effects of Dietary Sodium and Potassium Intake on Chronic Disease Outcomes and Risks

, and the health care system as a whole. Transparency and stakeholder input are essential to the Effective Health Care Program. Please visit the Web site ( to see draft research questions and reports or to join an email list to learn about new program products and opportunities for input. We welcome comments on this systematic review. They may be sent by mail to the Task Order Officer named below at: Agency for Healthcare Research and Quality, 5600 Fishers Lane, Rockville, MD (...) 20857, or by email to Gopal Khanna, M.B.A. Director Agency for Healthcare Research and Quality Stephanie Chang M.D., M.P.H. Director Evidence-based Practice Center Program Center for Evidence and Practice Improvement Agency for Healthcare Research and Quality Arlene S. Bierman, M.D., M.S. Director Center for Evidence and Practice Improvement Agency for Healthcare Research and Quality David W. Niebuhr, M.D., M.P.H., M.Sc. Task Order Officer Center for Evidence and Practice

2018 Effective Health Care Program (AHRQ)

96. WHO recommendations: intrapartum care for a positive childbirth experience

and Childbirth Group (of the Cochrane Collaboration) PICO population (P), intervention (I), comparator (C), outcome (O) PMNCH The Partnership for Maternal, Newborn & Child HealthWHO RECOMMENDATIONS: INTRAPARTUM CARE FOR A POSITIVE CHILDBIRTH EXPERIENCE viii PPH postpartum haemorrhage RCOG Royal College of Obstetricians and Gynaecologists RCT randomized controlled trial RHR Department of Reproductive Health and Research (at WHO) RMC respectful maternity care RR risk ratio SMD standardized mean difference TWG (...) of recommendation Third stage of labour Prophylactic uterotonics 41. The use of uterotonics for the prevention of postpartum haemorrhage (PPH) during the third stage of labour is recommended for all births. a 42. Oxytocin (10 IU, IM/IV) is the recommended uterotonic drug for the prevention of postpartum haemorrhage (PPH). a 43. In settings where oxytocin is unavailable, the use of other injectable uterotonics (if appropriate, ergometrine/ methylergometrine, or the fixed drug combination of oxytocin

2018 World Health Organisation Guidelines

97. Mental health care in the perinatal period: Australian clinical practice guideline

reviews or updates of this Guideline. Suggested citation Austin M-P, Highet N and the Expert Working Group (2017) Mental Health Care in the Perinatal Period: Australian Clinical Practice Guideline. Melbourne: Centre of Perinatal Excellence. Funding COPE acknowledges the funding provided by the Australian Government Department of Health for the development of this guideline. Publication approval The guideline recommendations on pages 7-12 of this document were approved by the Chief Executive Officer (...) (schizophrenia, bipolar disorder and postpartum psychosis) and borderline personality disorder at this time. The Guideline includes discussion of: • supporting emotional health and wellbeing of women • screening for symptoms of depression and anxiety and assessment for psychosocial factors that affect mental health • assessing mother-infant interaction and the safety of the woman and infant • referral and care pathways for women who require further assessment or care • care planning for women with diagnosed

2018 Clinical Practice Guidelines Portal

98. Group Prenatal Care

in outcomes and identifying populations that benefit most from specific care models. Introduction Individual prenatal care is intended to prevent poor perinatal outcomes and provide education to women throughout pregnancy, childbirth, and the postpartum period through a series of one-on-one encounters between a woman and her obstetrician or other obstetric care provider. The American College of Obstetricians and Gynecologists recommends routine regularly scheduled visits that consist of objective (...) , increased self-esteem, decreased social conflict, increased visit attendance, improved weight management, increased breastfeeding, increased rates of postpartum contraception, and decreased incidence of repeat pregnancy within 12 months (3, ). However, most study designs excluded adolescents who did not attend most of the scheduled visits, which resulted in additional selection bias. Group prenatal care also has been hypothesized to address the stressors borne by women in the military. An RCT of group

2018 American College of Obstetricians and Gynecologists

99. Promoting Risk Identification and Reduction of Cardiovascular Disease in Women Through Collaboration With Obstetricians and Gynecologists: A Presidential Advisory From the American Heart Association and the American College of Obstetricians and Gynecologi

a decreasing number of office-based general internists and a significant reduction of family physicians performing deliveries and suggests that the role of the OB/GYN should increase as the coordinator of women’s health care. Experts continue to emphasize the primary healthcare provider role for any young women at the entry point into the healthcare system. Because OB/GYNs are primary care providers for many women, the well-woman visit is the foundation of practice. The annual visit provides a powerful (...) affect the aggressiveness of the preventive treatment and may guide the initiation of preventive medications such as statins and antiplatelet drugs. All well-woman visits, including the postpartum follow-up visit, should be considered an opportunity to focus on lifestyle choices that optimize cardiac health, including weight management, smoking cessation, physical activity assessment, nutritional counseling, and stress reduction. This is especially important for those with pregnancy complications

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2018 American Heart Association

100. Influenza Vaccination During Pregnancy

, when it occurs during the antepartum or postpartum period. For example, a retrospective cohort study in Nova Scotia found that women hospitalized for respiratory illness during preg- nancy (especially during the third trimester) were more likely to have an increased number of medical visits or an increased length of stay when compared with the number of visits the year before their pregnancy (7). In this study, the association between pregnancy status and hospital admission was particularly (...) Influenza Vaccination During Pregnancy VOL. 131, NO. 4, APRIL 2018 OBSTETRICS & GYNECOLOGY e109 Influenza Vaccination During Pregnancy ABSTRACT: Influenza vaccination is an essential element of prepregnancy, prenatal, and postpartum care because influenza can result in serious illness, including a higher chance of progressing to pneumonia, when it occurs during the antepartum or postpartum period. In addition to hospitalization, pregnant women with influenza are at increased risk of intensive

2018 American College of Obstetricians and Gynecologists

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