For Your Consideration: ACOG Guidance Recommendations

Use of Antenatal corticosteroids at 22 weeks of gestation (ACOG September 2021): 

Gestation  Grade of Evidence Recommendations
20.0 – 21.6  1A Antenatal corticosteroids are not recommended due to the absence of data to suggest benefit. 
22.0 – 22.6 2C Antenatal corticosteroids may be considered if neonatal resuscitation is planned and after appropriate counseling
23.0 – 23.6 2B May be considered
24.0 + 1B Antenatal corticosteroids recommended

Research: A 2021 systematic review and meta-analysis that included 31 retrospective, observational studies of 2,226 infants who were delivered at 22 0/7 weeks to 22 6/7 weeks of gestation found that survival among infants born to pregnant individuals receiving antenatal corticosteroids was twice that of infants born to pregnant individuals not receiving antenatal corticosteroids (39.0% versus 19.5%; P<.01)

Article link: https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2021/09/use-of-antenatal-corticosteroids-at-22-weeks-of-gestation

 

 

Screening for colorectal cancer: USPSTF (ACOG endorsed September 2021):

Recommendation Grade of Evidence
Screening for colorectal cancer in all adults aged 50 to 75 years. A recommendation
Screening for colorectal cancer in adults aged 45 to 49 years B recommendation

The USPSTF recommends that clinicians selectively offer screening for colorectal cancer in adults aged 76 to 85 years. 

Patients and clinicians should consider the patient’s overall health, prior screening history, and preferences.

C recommendation

Article link: https://jamanetwork.com/journals/jama/fullarticle/2779985

 

 

Osteoporosis Prevention, Screening, and Diagnosis (ACOG September 2021):

Recommendation Grade of Evidence
Prevention: recommendation of routine aerobic physical activity and weight-bearing exercise Strong recommendation, moderate-quality evidence
Screening and diagnosis: screen in all postmenopausal patients 65+ with BMD testing  Strong recommendation, high quality evidence
Screen for postmenopausal patients <65 years who are at risk for osteoporosis from a clinical risk assessment tool  Strong recommendation, high quality evidence

Article Link: https://www.acog.org/clinical/clinical-guidance/clinical-practice-guideline/articles/2021/09/osteoporosis-prevention-screening-and-diagnosis

 

 

CDC STI treatment updates (July 2021): 

Topic Updates
Gonorrhea treatment  
  • A single 500mg injection of ceftriaxone
  • If chlamydial infection is not ruled out, treatment with a regimen of 100mg of oral doxycycline taken twice daily for 7 days. 
  • Retesting patients 3 months after treatment and that a test of cure be conducted for people with pharyngeal gonorrhea 1 to 2 weeks after treatment, using either culture or nucleic-acid amplification tests.  
Pelvic inflammatory disease (PID) treatment 
  • Metronidazole as the recommended treatment regimen for PID
Syphilis Screening 
  • Retest for syphilis at 28 weeks’ gestation and at delivery if the mother lives in an area where the prevalence of syphilis is high or if she is at risk of acquiring syphilis during pregnancy
Hepatitis C Screening 
  • Universal screening should be done during 1st trimester in pregnancy (ACOG endorsed September 2021)

Article Links:

https://www.cdc.gov/std/treatment-guidelines/STI-Guidelines-2021.pdf

https://www.ajog.org/article/S0002-9378(21)00639-6/fulltext