index

Page numbers followed by letters b, f, or t indicate boxes, figures, and tables, respec­tively.

A

Abnormal genital bleeding, 573-582 causes of, 573-574 diagnosis of, 574-575 differential diagnosis of, 573-574 management of, 575

Abnormal uterine bleeding (AUB), 573, 575-580

causes of, 576-577 classification of, 575-576, 576f diagnosis of, 577-579 evaluation of, 577-579 management of, 579-580

Abnormal uterine bleeding-leiomyoma (AUB-L), 577

Abnormal uterine bleeding-ovulatory

(AUB-O) dysfunction, 577

ABOG.

Abortion

defined, 717 induced, 717-723

access to care, 717 complications of, 719 evaluation before, 720 legal issues related to, 717-718 management of, 720-721 methods of, 718-719 mortality data, 719

patient counseling related to, 719-720 prevalence of, 717

spontaneous, 707,709 timing of, 718

Abortion rate, decrease in, 717

Abortion ratio, decrease in, 717

Abuse, 537-553. See also Violence; specific types alcohol, 334-338 of children, 545-548, 547b domestic violence, 537-543, 540b, 542b drug, 334-338 elder, 487, 543-545 intimate partner violence, 537-543, 540b, 542b

prescription drug misuse, prevention of, 338

rape, 549-550, 551b reproductive coercion, 548-549 sexual, in adolescents, 458-459 sexual, in children, 430-431, 545-548, 547b

adult manifestations of, 545-548, 547b defined, 545

evaluation of, 430 examination findings, 431 forensic evidence of, 430 human immunodeficiency virus infection related to, 546

prevalence of, 430

reporting of, 431

screening for, 546, 547b

sexually transmitted infections due to, 431, 546

support for survivors of, 546, 548 treatment for, 431

sexual assault, 549-550, 551b

sexual coercion, 548-549 substance, 329-341 types of, 537 of women with disabilities, 515

ACA. See Patient Protection and Affordable

Care Act

ACC.

for homeless women, 210-212

for undocumented immigrants, 209-210 for the uninsured, 208-209 for women in the military and women veterans, 212-213

Accommodation(s), under Americans with

Disabilities Act

public accommodations, 801 reasonable accommodations, 800-801 Accreditation Commission for Midwifery

Education, 189

Accreditation Council for Graduate Medical

Education, 187, 841

Accreditation Review Commission on

Education for the Physician Assistant, 191

ACOG. See The American Congress of Obstetricians and Gynecologists Acupuncture, during menopause, 476 Ad hoc committees, 8

ADA. See Americans with Disabilities Act Adhesion(s), labial, in children, 426-427 Adjustable gastric banding, for weight loss, 250

Administration, governance and, 1-134 Admitting privileges, 24

Adolescent(s), 435-467. See also Minor(s);

Primary and preventive care alcohol abuse among, 448-449 behavioral risk factors in, 436-438 body mass index in, 444 body piercing and tattoos, 449 calcium intake in, 447 caloric intake in, 247-249, 248t confidentiality in health care for, 438-441, 442t addressing, 441, 442t compromised, 439 described, 438-439 legal considerations in, 439-441 office procedures ensuring, 439 counseling of lifestyle-related, 447-452, 450b unintended pregnancy-related, 456 depression in, 449-451, 450b

Adolescent(s) (continued)

development of, 435-438, 436b, 437b with disabilities, gynecologic health care for, 459-462

eating disorders in, 445 endometriosis in, 589-591. See also Endometriosis

examination procedures, 441-447 menstrual history, 437b, 443 pubertal progress, 443 health risks for, 436-438 hypertension in, 443-444 immunizations in, human papillomavirus, 446

initial reproductive health-related visit for, 435-436

lipid disorders in, 444 menstrual conditions in, evaluation required for, 437b, 443

menstrual cycles in, 436b motor vehicle accidents among, 451 obesity in, 444-445 pregnancy in

prevalence of, 454-455 risk factors for, 454-456 unintended, 456 rape among, 458 reproductive coercion among, 457 as research participants, 11-12 sexual coercion among, 457 sexuality and, 452-459 abstinence-only education, 453 anal sex, 456 condom use, 455 education, 452-454 emergency contraception, 455 noncoital sexual activity, 456 oral sex, 456

pregnancy risk, 454-456 sexual abuse, 458-459 sexual activity, 455 sexual and reproductive coercion, 457

sexual assault, 458-459 sexual identity, 452 unintended pregnancy options counseling, 456 smoking among, 331, 447-448 sexually transmitted infections in, 436-437, 445-446, 453-456 Adolescent(s) (continued) substance abuse among, 448-449 suicide in, 449-451, 450b unintended pregnancy among, counseling related to, 456 violence and, 451-452 vitamin D intake in, 447 withdrawal contraceptive method among, 365

Adult Protective Services, on elder abuse, 544-545

Advance care planning, 517-526

Advance directive(s) defined, 519 patient's rights and, 126-127 types of, 519

Adverse outcome events, risk management associated with, 84

Advisory Committee on Immunization Practices, of Centers for Disease Control and Prevention, 388, 400

Aerobic exercise, 259-260

Affordable Care Act.

Aftercare, ethics in, 164-165

Agency for Healthcare Research and Quality

on annual health assessment, 21 on tobacco dependence, 330, 330b Aging

cognitive changes with, 481-483 decreased bone mass related to, 295

Alcohol abuse, 334-338 in adolescents, 448-449 among older women, 486-487 deaths due to, 334 gynecologic consequences of, 334 intervention for, 337 prevention of, 338 screening and assessment for, 335, 336t

treatment of, referral for, 337 Alcohol use, prevalence of, 329 Allergic reactions, ambulatory gynecologic surgery and, 743

Allergy(ies), latex, 140-141 Alzheimer disease, 482

AMA. See American Medical Association Ambulatory gynecologic care, governance of, 12

Ambulatory gynecologic care facilities, 137-146

general requirements, 137-139 inpatient facilities, 144-145 office settings, 142-143 physical and supply requirements, 139-142

surgical facilities, 143-144 Ambulatory gynecologic surgery, 725-748

adverse reactions to, 742-743 anesthesia for, 730-735, 731b, 732t continuum of depth of, 732t general anesthesia, 731b, 732t intraoperative care, 734-735 risk factors related to, 733-734 selection of, 730-733, 731b, 732t types of, 731b

cosmetic surgery, 744-745 discharge-related issues, 743-744 facilities and equipment for, 725-730, 726b-727b, 730b

intraoperative care, 740-741 limitations on, 725

patient selection for, 727b-728b postoperative care, 741-742 preoperative care, 735-738, 739b-740b

evaluation and tests, 735-738 protocols and checklists, 738, 739b-740b

recovery period following, 743 regulations on, 725-726, 726b-728b Ambulatory women's health care services, scope of, 202b-203b Amenorrhea, 567-572

adverse effects, 571

anorexia nervosa and, 528 causes of, 567, 568t, 569t defined, 567

evaluation of, 568-570 hypothalamic, 571 management of, 570-571 osteoporosis due to, 571 primary, 567, 568t secondary, 567, 569t

American Academy of Pediatrics on alcohol abuse, in adolescents, 448-449

on female genital examinations, 421

American Academy of Pediatrics (continued) on sexual abuse

in adolescents, 459

in children, 431

American Academy of Physician Assistants, information on, 842

American Association of Colleges of Osteopathic Medicine, 187

American Board of Medical Specialists, on certification, 20, 21b

American Board of Obstetrics and

Gynecology (ABOG), 186 certificates issued by, 20, 21b on imaging services, 161 information on, 842

American Cancer Society

on breast cancer screening, 317

on breast self-awareness, 226

on cancer-related deaths, 311

on cervical cancer, 319

on endometrial cancer, 321

on vaginal cancer, 649

American College of Cardiology (ACC) on dyslipidemia, 280 on hypertension, 277-278 obesity management guidelines of, 245, 249, 250

American College of Nurse-Midwives, 193, 842-843

American College of Obstetricians and Gynecologists.

American College of Osteopathic Obstetricians & Gynecologists, information on, 843

American College of Radiology, 162,

314- 315

American College of Surgeons, on ambula­tory gynecologic surgery, 741

American Congress of Obstetricians and Gynecologists. See The American Congress of Obstetricians and Gynecologists

American Diabetes Association, 289 criteria for testing for diabetes in asymp­tomatic adults of, 287-289, 288b on interconception care, 393 Standards of Medical Care in Diabetes of, 290

American Geriatric Society, Beers Criteria for Potentially Inappropriate Medication Use in Older Adults of, 488

American Heart Association

on cardiovascular disease in older women, 484

on dyslipidemia, 280

on hypertension, 277-278 on metabolic syndrome, 274 obesity management guidelines of, 245, 249, 250

American Institute of Ultrasound in Medicine, 162

on guidelines for cleaning and preparing endocavitary ultrasound transducers between patients, 153b information on, 843

American Medical Association (AMA) Council on Ethical and Judicial Affairs of, 112

on credentialing, 18 on impaired practitioner behavior,

34 information on, 843 on medical records, 170 on physician reentry, 28 on professional behavior, 96

American Midwifery Certification Board, Inc., 189, 193

American Nurses Association, 189

American Nurses Credentialing Center,

20

American Osteopathic Association,

187

American Osteopathic Board of Obstetrics and Gynecology, 186-187

American Pain Society, on pain management, 599, 600b

American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders

on depression management, 561 on depression screening, 556-558, 557b-558b

on eating disorders, 528

on female sexual dysfunction, 675, 678, 678t-679t

on premenstrual dysphoric disorder,

610

on vulvodynia, 624

American Recovery and Reinvestment

Act of 2009, Health Information

Technology for Economic and Clinical Health Act of, 810

American Society for Colposcopy and Cervical Pathology, 635, 639-641, 640t

on cervical cytology screening in adolescents, 447

information on, 844

on vaginal cancer, 649

American Society for Reproductive Medicine on amenorrhea assessment and

treatment, 570-571

on endometriosis, 583, 584f-585f

on infertility, 703 information on, 844

on posthumous reproduction, 524

on recurrent pregnancy loss, 713

American Society of Anesthesiologists (ASA) on ambulatory gynecologic surgery,

727b, 729-730, 730b, 734-735

physical status classification system of,

729- 730, 730b

on sedation, 734-735

American Urogynecologic Society, information on, 844

Americans with Disabilities Act (ADA), 511, 799-803

auxiliary aids, 802

described, 799

employment obligations, 800

impairments covered by, 799

on patient safety, 73

physician requirements, 801-802 public accommodations, 801 qualifications under, 800

reasonable accommodations, 800-801 resources, 802-803

Title III of, 511

Amsel criteria, for bacterial vaginosis, 616

Anal sex

among adolescents, 456

health risks associated with, 414-415

Analgesia and analgesics, 162-163,

730- 735, 731b, 732t

Analytical observational studies, 817, 817f

Ancillary services, 157-166

analgesia, 162-163

anesthesia, 162-163

Ancillary services (continued) follow-up services, 163-165 imaging services, 160-162 laboratory services, 159-160 pathology services, 159-160 pharmacy services, 157-159

Anesthesia and anesthetics, 162-163, 730-735, 731b, 732t

Annual health assessment, 217-231.

clinical breast examination in, 226-227 importance of, 218-219

medical history in, 219-225, 220b, 222b pelvic examination in, 218, 227-229 physical examination in, 218, 225-226 Anorexia nervosa, 528-529, 529b

behaviors associated with, 529 defined, 528 features of, 528

medical complications of, 530 subtypes of, 529b

Antibiotic prophylaxis, 737

Antibiotics, in urinary tract infection management, 699-701

Antidepressants, tricyclic, for depression, 561

Antifibrinolytic drugs, in abnormal uterine bleeding management, 579

Anxiolysis

continuum of depth of, 732t defined, 731b

Appointment scheduling management of, 196-197 rescheduling, 196

Aromatase inhibitors, in leiomyoma management, 595

ART. See Assisted reproductive technology ASA. See American Society of

Anesthesiologists

Assisted reproductive technology (ART) in genetic risk assessment, 307 infertility-related, 704

Association for Hospital Medical Education, information on, 844-845

Association for Perioperative Registered Nurses, Inc., information on, 845

Association of Physician Assistants in Obstetrics and Gynecology, information on, 845

Association of Professors of Gynecology and Obstetrics, information on, 845-846

Association of Reproductive Health Professionals, information on, 846

Association of Women's Health, Obstetric and Neonatal Nurses, information on, 846

Atrophic vaginitis, 620

AUB. See Abnormal uterine bleeding

AUB-L. See Abnormal uterine bleeding­leiomyoma

AUB-O dysfunction. See Abnormal uterine bleeding-ovulatory dysfunction Autonomic dysreflexia, in women with disabilities, 514-515

Autonomy

in advance directive, 126-127 defined, 118

honesty and, principle of respect for, 125-126

in informed consent, 122, 124 in principle-based ethics, 118

B

Bacterial vaginosis, 616-617

Amsel criteria for, 616 causes of, 616 defined, 616 symptoms of, 616 treatment of, 617

Barrier contraceptive methods, 364-365, 415

Basson's nonlinear female sexual response model, 674, 674f

Beers Criteria for Potentially Inappropriate Medication Use in Older Adults, of American Geriatric Society, 488 Beneficence, defined, 118

Bethesda System, for reporting cervical cytology, 635, 636b-638b

BI-RADS.

Bigendered, defined, 506b

Bilateral oophorectomy, hysterectomy with or without, in endometriosis management, 589

Bill of rights, patient's, purpose of, 127-128

Billing, 193-195

coding, 194b, 233

fraud, 110-111

practices, 83-84

Bimanual examination, in annual health assessment, 229

Binge-eating/purging disorder, 530-531 Bioethics consultants, 131

Biologically based practices, 266-267 Bisexual women, 499-503

barriers to health care for, 499 diversity among, 499

legal issues related to, 501 psychosocial concerns of, 500-501 routine health visits for, 500 welcoming patient care environment for, 501-502

Bisphosphonates, in osteoporosis preven­tion and treatment, 301

Bladder function, in older women, 483 Bleeding

abnormal, hydatidiform mole and, 659 abnormal uterine, 573, 575-580 genital, abnormal, 573-582

heavy menstrual, defined, 575

Blood glucose control, in preconception care, 382-383

Blood pressure. See also Hypertension classification of, 276, 276t diabetes mellitus and, 291 measurements of, 277, 278b

Bloodborne pathogens. See also Infection control

occupational exposure to, Occupational Safety and Health Administration regulations on, 87-89, 773-786 prevention of, 147-156

BMD. See Bone mineral density

BMI. See Body mass index

Body mass index (BMI)

calculation of, 245

in preconception care, 386

Body piercing, in adolescents, 449

Bone loss, causes of, 295, 296b

Bone mass, decrease in, osteoporosis due to, 295, 296b

Bone mineral density (BMD)

in adolescents, 444

in breast cancer patients, monitoring

of, 646

Bone mineral density (BMD) (continued) depot medroxyprogesterone acetate effects on, 357

loss of, 295

Bone mineral density screening, for osteo­porosis, 297-299, 298/, 300b, 300t

American College of Obstetricians and Gynecologists on, 297-299, 298f before age 65 years, 299, 300b dual energy X-ray absorptiometry in, 299 fracture risk assessment tool in, 299, 300t

Borderline personality disorder, 534 Bowel function, in older women, 483 BRCA1 mutation, 316, 317, 323, 654 BRCA2 mutation, 316, 317, 323, 654 Breast cancer, 312-319, 643-648 contraceptive use in, 647-648 deaths due to, 312, 312t, 643 evaluation and diagnosis of, 644 fertility and, 648

hormone therapy and, 472 incidence of, reducing, 318-319 lifetime risk of developing, 643 management of, 644-648 menopausal symptoms and, 646-647 National Cancer Institute on risk of, 319 osteoporosis and, 645-646 prevalence of, 643 risk factors for, 312-313, 313t, 318-319, 643

screening for, 314-319 clinical breast examination in,

315- 316, 315/

diagnostic mammography in, 318 digital breast tomosynthesis in,

316- 318

enhanced, 316 magnetic resonance imaging in, 316-317

mammography in, 314-315, 643 patient self-screening in, 316 ultrasound in, 316-317 in women with disabilities, 514 sexual function and, 648 vaginal dryness and atrophy and, 647 Breast Cancer Risk Assessment Tool, 319 Breast examination

in annual health assessment, 218, 226-227

Breast examination (continued)

clinical, in breast cancer screening, 315-316, 315/

Breast Imaging Reporting and Data System (BI-RADS), of American College of Radiology, 314-315

Breast self-awareness

American Cancer Society on, 226 breast cancer screening, role in, 226, 314, 316

definition of, 226, 316

National Comprehensive Cancer Network on, 226

The American College of Obstetricians and Gynecologists on, 226

Breast self-examination, in breast cancer screening, 316

Breastfeeding, contraceptive methods while, 371-372

Bulimia nervosa, 529-530

defined, 529

medical complications of, 530

Bupropion

for depression, 561

in smoking cessation, 332-334, 333t

C

Calcitonin, in osteoporosis prevention and treatment, 302

Calcium intake, 255

in adolescents, 447

in amenorrhea management, 571

in female-to-male transgender individuals, 508

during menopause, 470

Caloric intake, in weight loss, 247-249, 248t CAM. See Complementary and alternative medicine

Cancer(s). See also specific types breast, 312-319, 643-648 cervical, 319-321, 649-651 colon, 323-324

colorectal, 323-324 deaths due to, 311, 312t diagnosis of, 643-644 endometrial, 321, 651-654 fertility preservation and, 660 gestational trophoblastic disease, 658-660

lung, 324-325

Cancer(s) (continued) in older women, 485 ovarian, 322-323, 654-656 risk factors for, evaluation of, 311 screening for, 311-328 breast cancer, 312-319 cervical cancer, 319-321 colon cancer, 323-324 colorectal cancer, 323-324 endometrial cancer, 321 lung cancer, 324-325 ovarian cancer, 322-323 in transgender individuals, 507 in women with disabilities, 514 vaginal, 649-651 vulvar, 656-657

Candidiasis, vulvovaginal, 617-618, 618b Cardiovascular disease (CVD), 273-285 deaths due to, 273 dyslipidemia, 279-280 hormone therapy and, 473 hypertension and, 275-279 metabolic syndrome and, 274-275 in older women, 484 polycystic ovary syndrome and, 669 risk factors for, 273 thromboembolic disease, 280-282 Cardiovascular disorders. See specific types;

Cardiovascular disease

Care coordination, 195 Case-based reasoning, 121 Case-control studies, 817, 817f, 824-826, 825f

CDC. See Centers for Disease Control and Prevention

Centers for Disease Control and Prevention (CDC)

Advisory Committee on Immunization Practices of, 388, 400 on cleaning and disinfecting equipment in infection control, 153 on Clinical Laboratory Improvement Amendments, 787

on environmental infection control, 153-154

“Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings in 2007” of, 148-149 on hand hygiene, 70, 147-148

Centers for Disease Control and Prevention (CDC) (continued)

on human immunodeficiency virus infection, 413, 414

on hypertension, 277-278

on immunizations for health care providers, 105-106

on induced abortion, 718

on infectious disease prevention, 104

on infectious vulvovaginitis, 424

on management of infected health care professionals, 151-152

on obesity in adolescents, 444

on occupational exposures, 88

on proper use of male condoms, 401b

on sexual abuse in children, 431

on sexually transmitted infections screening, 403, 445-446

on trichomoniasis, 619

on universal precautions, 776

U.S. Medical Eligibility Criteria for Contraceptive Use, 2010 of, 291-292, 346, 647

U.S. Selected Practice Recommendations for Contraceptive Use, 2013 of, 347-349

on vulvovaginal candidiasis, 617 Centers for Medicare & Medicaid Services (CMS), 89, 223, 224

on Clinical Laboratory Improvement Amendments, 787

on electronic health records, 170 Certificate for provider-performed microscopy procedure, from Clinical Laboratory Improvement Amendments, 788-790 Certificates of waiver, Clinical Laboratory Improvement Amendments and, 787-788

Certification. See also Credential(s); Credentialing

by American Board of Obstetrics and Gynecology, 20, 21b

for certified midwives, 189

for certified nurse-midwives, nurse practitioners, and physician assistants, 20, 189

duration of, 20

maintenance requirements, 20, 21b

Certification (continued)

medical specialty board, 19

for medical staff appointments, 19-21, 19b, 21b

Certified midwives (CMs), certification and training of, 189

Certified nurse-midwives (CNMs) certification and training of, 20, 189 clinical privileges of, 24

Cervical cancer, 649-651

deaths due to, 649

evaluation and diagnosis of, 650 incidence of, 649

management of, 650-651

in older women, 649

prevalence of, 319

screening for, 319-321, 514

Cervical cytology screening

abnormal results on, 635-642 evaluation and management of, 639-641, 640t

reporting of, 635, 636b-638b

American College of Obstetricians and Gynecologists on, 442-443 in adolescents, 446-447

Bethesda System for reporting, 635, 636b-638b

in cervical cancer, 319-321, 649

in preconception care, 386

Cervical intraepithelial neoplasia (CIN), 635, 637b

Cervicitis, diseases characterized by, 408t-411t

Chancroid, genital ulcers and, 407t-408t Chaperone(s), during physical examination, 100

Chemotherapy, in breast cancer manage­ment, 644

Chief complaint, in medical history, 223 Child abuse, 545-548, 547b

categories of, 545

manifestations of, 545 physical, 545 prevalence of, 545 screening for, 430-431, 546, 547b sexual, 545-548, 547b

support for survivors of, 546, 548 Childhood sexual abuse, 545-548, 547b Children, abuse of, 545-548, 547b. See also Pediatric gynecology

Chlamydial infection

in adolescents, 455

cervicitis and, 408t-411t

in children, 431

evaluation for, nucleic acid amplification tests in, 229

urethritis and, 408t-411t Cholelithiasis, hormone therapy and,

472

Cholesterol, abnormal levels of, 279-280

Chronic gynecologic pain, 623-628. See also specific causes and types

Chronic medical conditions, counseling related to, in preconception care, 389

Chronic pelvic pain, 627

Cigarette smoking, 330-334. See also Smoking

CIN. See Cervical intraepithelial neoplasia Civil Rights Act of 1964

Title VI of, 805-806

Title VII of, 111

CLIA. See Clinical Laboratory Improvement Amendments of 1988

Clinical breast examination, in breast cancer screening, 315-316, 315f

Clinical Laboratory Improvement Amendments of 1988 (CLIA), 87, 89-90, 787-791

on abnormal cervical cytology, 639 certificate for provider-performed microscopy procedure, 788-790 certificate(s) of waiver, 787-788 Clinical nurse specialists, certification and training of, 189

Clinical research, types of, algorithm for classification of, 815, 816f

Clinical studies, hierarchy of, 816, 817f Clinical trials

conflict of interest related to, 108-109 randomized, 817f, 818-821, 820t Clonidine, in menopausal symptom man­agement in breast cancer patients, 646

CME. See Continuing medical education CMS. See Centers for Medicare & Medicaid Services

CMs. See Certified midwives

CNMs. See Certified nurse-midwives

Code of Professional Ethics, of the American College of Obstetricians and Gynecologists, 73, 97, 749-755 code of conduct, 751-755 ethical foundations of, 749-751 on impaired clinicians, 102-103 overview of, 749

Coding. See Billing

Cognitive function, in older women, 481-483

Cohort studies, 816/, 817, 817/, 822-824, 822b, 824/

Colon cancer, screening for, 323-324 Colorectal cancer, screening for, 323-324 Combined hormonal contraceptives, 262b-363b, 358-361, 360b

Combined hormone therapy. See Hormonal therapy

Committee(s)

of Department of Obstetrics and Gynecology, 7-9, 8b

ad hoc, 8 purpose of, 7 responsibilities of, 7-8 standing, 8

institutional ethics, 129-131 items for review by, 7, 8b

Communication electronic

confidentiality and, 98

in quality improvement in inpatient setting, 44

in end-of-life considerations, 517-518 in informed consent, 122

in medical history interview, 219-221, 220b

with older women, 479-480 patient-related, management of, 172-179

patient safety-related, 70-74

in quality improvement in inpatient setting, 42-44

Communitarian ethics, 121

Competence, continuing evaluation for, 30-32

Complementary and alternative medicine (CAM), 265-271

biologically based practices, 266-267 defined, 265

energy medicine, 267

Complementary and alternative medicine (CAM) (continued) health care provider education related to, 269-270 manipulative and body-based practices, 267

during menopause, 476 mind-body practices, 265 patient use and interest in, 268-269 prevalence of, 265

safety concerns with, 267-268 types of, 265-267

whole medical systems, 265-266 Compliance, with government regulations, 87-93. See also Government regulations

Compounded bioidentical menopausal hormone therapy, 474-475

Compounding law, of U.S. Food and Drug Administration, 158-159

Condom(s), 364-365 adolescents use of, 455 female, 402 male, Centers for Disease Control and Prevention on proper use of, 401b in sexually transmitted infections pre­vention, 401-402, 401b types of, 401-402, 401b

Condyloma acuminata, in children, 425-426

Confidentiality

in adolescent health care, 99, 438-441, 442t

described, 13, 438

of electronic health records, 171-172 electronic communication and, 98, 177-179, 178b, 180b

electronic media and, 98

ethics of, 126

human immunodeficiency virus testing and, 98

intimate partner violence-related, 543 maintaining, 97-99

of medical records, 168-169

U.S. Department of Health and Human Services on, 98

third party protection and, 99

Conflicts of interest, 107-110 acceptance of gifts, 109 avoidance of, ethical foundation for, 750

Conflicts of interest (continued)

clinical trials and, 108-109

code of conduct for, 753-754

health care industry representatives and, 109

limitations on commercial support of Continuing Medical Education, 110 medical device training and, 110 patents and, 108

pharmaceutical samples and, 109-110 regulatory bodies and managed care organizations and, 108

Confounding, example of, 823, 824f Confounding variables, 823, 823b Conscientious objection, ethical issues in, 124-125

Consent. See also Informed consent

in educational programs, 10

in emergency medical conditions, 795-797

for women with developmental disabili­ties, 514

Consultation(s)

in endometrial cancer management, 653-654

remote, 179

Contact vulvovaginitis, 620

Continuing competence, evaluation for,

30-32

Continuing education, 10-12

Continuing medical education (CME), commercial support of, limitations on, 110

Contraception. See Contraceptive(s) Contraceptive(s). See also specific types;

Family planning

in amenorrhea management, 571

in breast cancer patients, 647-648 breastfeeding and, 371-372 categories of medical eligibility criteria for, 350, 351b

counseling related to, in family planning, 348-349

failure of, 374-375

history of use, in family planning, 346 injectable, 356-358

methods, 351-371

barrier methods, 364-365 combined hormonal contraceptives, 358-361, 360b, 362b-363b,

Contraceptive(s), methods (continued) condoms, 364-365 contraceptive implants, 355-356 contraceptive patch, 361, 362b-363b emergency contraception, 366-371, 368t-370t

fertility awareness-based methods, 365

injectable contraception, 356-358 intrauterine devices, 352-355 oral contraceptives, 359-361, 360b over-the-counter products, 364-365 progestin-only pills, 363-364 spermicides, 364 sponges, 364 sterilization, 351-352 vaginal ring, 361, 362b-363b withdrawal, 365 in older adults, 350 in postpartum period, 371-374, 373t-374t

back-up contraception, 372-373 breastfeeding and, 371-372 timing of initiation of, 372, 373t-374t in preconception care, 382 steroid, in leiomyoma management, 594 unintended pregnancies and, 343, 344t-345t

in women with coexisting medical conditions, 350, 351b

in women with diabetes, 291-292 in women with disabilities, 515

Contraceptive implants, 355-356, 355b Contraceptive patch, 361, 362b-363b Core privileging, 23-24

Cosmetic procedures, ambulatory gynecologic, 744-745

Council of University Chairs of Obstetrics and Gynecology, information on, 846

Counseling

for adolescents, lifestyle-related, 447-452, 450b

contraceptive use-related, in family planning, 348-349

genetic, in preconception care, 391 induced abortion-related, 719-720 infertility-related, 704 in interconception care, 394-395 menopause-related, 470

Counseling (continued)

in preconception care, 382, 387-392 chronic medical conditions, 389 depression and psychiatric illness, 392 domestic violence-related, 392 environmental factors, 390 genetic counseling, 391 immunizations, 388

intimate partner violence-related, 392 maternal age-related, 390-391 medication use, 390

nutrition, 388-389 substance use and abuse-related, 391 weight, 388-389

recurrent pregnancy loss-related, 714-715 telephone, in smoking cessation, 332 unintended pregnancy-related, for adolescents, 456

Credential(s), evaluation of, 17-21. See also Certification; Credentialing

Credentialing. See also Credential(s); Certification

described, 757

information sources, 17-19, 19b medical staff appointments and, 17-21, 19b, 21b

privileges granted after, 22-30 requirements, 17-18

Cross-sectional studies, observational, 826-829, 827f, 829f

Crossdresser, defined, 506b

Cultural sensitivity and awareness, in patient safety, 72-73

Culture, of patient safety, 64-65, 64b CVD. See Cardiovascular disease (CVD) Cystitis, 697, 699

D

Dairy-free diet, 258

D&C. See Dilation and curettage

Decision analysis, of medical evidence, 831

Decision making

ethics in, 118-121, 129-131

health care, Patient Self-Determination Act of 1990 on, 519

Delirium, in older women, 481-483 Department chair (head)

as quality improvement committee chair, 42

responsibilities of, 5-7

Department meetings, in quality improve­ment in inpatient setting, 42-44 Department of Defense, TRICARE program of, 212

Department of Obstetrics and Gynecology committees of, 7-9, 8b education and research in, 9-12 formulation of policies by, department members in, 6-7

functional responsibility of, 4 governance of, 3-12 head of, responsibilities of, 5-7 meetings of, 9 officers of, 5-7 organization of, 3-5 functions fulfilled by, 3 size and type of institution in, 4-5 Depot medroxyprogesterone acetate (DMPA), 356-358

bone mineral density loss related to, 357 in diabetics, 291

side effects of, 357-358

Depression, 555-563

in adolescents, 449-451, 450b

age at onset of, 555

costs related to, 555

counseling related to, in preconception care, 392

diagnostic criteria for, 557b-558b

differential diagnosis of, 559 management of, 560-561 in older women, 481, 486 in postpartum period, 394 prevalence of, 555 recurrence of, 555 screening for, 555-558, 557b-558b symptoms of, 556-559, 556b-558b Descriptive studies, 817, 817f, 829-830 Desquamative inflammatory vaginitis, 620 Developmental disabilities, adolescents with, gynecologic health care for, 459-462

DHHS. See U.S. Department of Health and Human Services

Diabetes mellitus, 287-293

blood pressure and, 291 causes of, 287

contraceptive use and, 291-292 described, 287

diagnosis of, 289-290, 289t

Diabetes mellitus (continued)

gestational, 287, 292 management of, 290-292 polycystic ovary syndrome and, 669 prevention of, 287-289, 288b screening for, 289-290, 289t types of, 287

undiagnosed, prevalence of, 287 Diagnostic and Statistical Manual of Mental Disorders, of American Psychiatric Association

on depression management, 561 on depression screening, 556-558, 556b-558b

on eating disorders, 528

on female sexual dysfunction, 675, 678, 678t-679t

on premenstrual dysphoric disorder, 610 on vulvodynia, 624

Diagnostic mammography, in breast cancer screening, 318

Diet(s), special, 257-258

Dietary fiber, intake of, 253, 255

Dietary Guidelines for Americans, of U.S. Department of Agriculture, 251-256, 251b-254b

Dietary reference intakes, 251-256, 251b-254b

Dietary therapy, for weight loss, 247-249, 248t

Digital breast tomosynthesis, in breast cancer screening, 316-318

Dilation and curettage (D&C)

in abnormal uterine bleeding management, 580

in induced abortion, 718 Disability(ies)

adolescents with, gynecologic health care for, 459-462

defined, 511, 799

qualified individual with, under Americans with Disabilities Act, 800

women with, 511-516

Disruptive behavior, by practitioners, 35

DMPA. See Depot medroxyprogesterone acetate

“Do Not Use” list of nonstandard abbrevia­tions, of The Joint Commission, 65, 66t

Domestic violence. See Violence Drug(s). See also Medication(s);

Prescription drug(s); specific drugs control and disposal of, in practice management, 197-198 illicit, prevalence of use, 329 painkillers, deaths due to, 334 in smoking cessation, 332-334, 333t for weight loss, 249 Drug abuse, 334-338 intervention for, 337 prevalence of, 329 prevention of, 338 screening and assessment for, 335, 336t testing for, 335-337 treatment of, referral for, 337

Drug samples labeling of, 158 storage of, 158 Drug testing, 335-337 Dual energy X-ray absorptiometry (DXA), in bone mineral density screening, 299

DXA. See Dual energy X-ray absorptiometry Dysfunctional uterine bleeding. See

Abnormal uterine bleeding Dyslipidemia, 279-280 in adolescents, 444 evaluation of, 279-280, 281b identification of, 279-280, 281b management of, 280

Dyspareunia, in postmenopausal women, management of, 633

E

Early fetal death, 707

Early pregnancy complications, 707-712.

See also specific types early pregnancy loss, 707-709. See also

Pregnancy loss, early ectopic pregnancy, 709-711 molar pregnancy, 711

Eating disorders, 528-533. See also specific types

in adolescents, 445

anorexia nervosa, 528-529, 529b assessment of, 532-533 binge-eating/purging disorder, 530 bulimia nervosa, 529 health consequences of, 530-531, 531b

Eating disorders (continued)

management of, 533 presentations of, 530, 531 b screening for, 532-533 types of, 528-530

Economic analysis, of medical evidence, 831-832

Ectopic pregnancy, 709-711

diagnosis of, 710

management of, 710-711 prevalence of, 709 risk factors for, 709

Educational programs

in Department of Obstetrics and Gynecology, 9-12

ethical obligations in, 10

patient consent in, 10

EHRs. See Electronic health records

Eighth Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, 277

Elder abuse, 487, 543-545

American College of Obstetricians and Gynecologists on, 543 assessment for, 543-544, 544b described, 543 reporting of, 544-545

Elder mistreatment. See Elder abuse

Elderly. See Women 65 years and older Electronic communication

confidentiality and, 98

with patient, 177-179, 178b, 180b in quality improvement in inpatient setting, 44

Electronic health records (EHRs)

advantages of, 170

confidentiality of, 171-172 management of, 170-172 protection of, 171-172 tracking and follow-up of, 171 transfer of data among systems, 171

Emergency contraception, 366-371, 368t-370t

access to, 367

in adolescents, 455 effectiveness of, 367 indications for, 366-367, 371 levonorgestrel in, 366, 368t progestin-only pills in, 366

Emergency medical conditions. See also Emergency Medical Treatment and Labor Act

defined, 794

determination of, 794 general requirements, 797-798 treatment for, 795-798

patient's refusal to consent, 795-797 procedure-related, 795

transfer of patient to another medical facility, 796-797

Emergency medical treatment, government regulations for, 87, 90-91

Emergency Medical Treatment and Labor Act (EMTALA), 87, 90-91, 793-798. See also Emergency medical conditions

enforcement and penalties, 798 general, 797-798

medical screening examination, 793-794

patient qualification, 794 pregnant women qualification, 794-795 treatment-related, 795-798

EMTALA. See Emergency Medical Treatment and Labor Act

End-of-life considerations, 517-526 communication in, 517-518 legal rights, 519-521 palliative strategies in, 518 posthumous reproduction, 523-524 respect for patient values and beliefs, 517-518

terminal care, 521-523 hospice care, 522-523 hospital care, 521-522 pain management, 523

Endocavitary ultrasound transducers, cleaning and preparing of, 153b

Endometrial ablation

in abnormal uterine bleeding management, 580

in leiomyoma management, 596

Endometrial biopsy, in endometrial cancer evaluation, 652

Endometrial cancer, 651-654 causes of, 321 deaths due to, 651 evaluation and diagnosis of, 652-653 hormone therapy and, 472

Endometrial cancer (continued) lifetime risk of developing, 651 management of, 653-654 prevalence of, 321, 651 risk factors for, 651 screening for, 321

Endometrial tissue sampling, in abnormal uterine bleeding evaluation, 578

Endometriosis, 583-592

in adolescents, 589-591

differential diagnosis of, 589 evaluation and diagnosis of, 590 management of, 590-591 classification of, 583, 584f-585f defined, 583 differential diagnosis of, 586 evaluation and diagnosis of, 586-587 management of, 587-589

nonsurgical interventions in, 587-588

referral in, 589

surgical, 588-589

prevalence of, 583

symptoms of, 586

Energy medicine, 267

Environmental factors, in preconception care, 386, 387b, 390

Environmental infection control, 153-154 Epidemiologic studies, 815-830. See also specific types

observational studies, 822-830 randomized clinical trials, 817f, 818-821, 820t

types of, 815-818, 816f, 817f Equipment, 137-146

cleaning and disinfecting of, in infection control, 152-153, 153b

general requirements, 137-139, 140b latex products sensitivity, 140-141 personal protective, Occupational Safety and Health Administration on, 778-779

single-use medical device reprocessing, 141-142

Estrogen agonists/antagonists. See Selective estrogen receptor modulators

Estrogen therapy. See Hormone therapy Ethics, 117-134

in aftercare, 164-165

autonomy, 118

Ethics (continued)

beneficence, 118-119

of care, 120

communitarian, 121 confidentiality and, 126 conscientious objection, 124-125 in decision making, 118-121, 129-131

defined, 117

educational programs and, 10

feminist, 120-121

foundations of, 118-121

in genetic risk assessment, 307

honesty and, 125-126

importance of, 117-118

informed consent, 121-124 institutional ethics committees, 129-131

justice, 119

nonmaleficence, 118-119

patient protection-related, 126-129 in practice, 121-126

principle-based, 118-120

virtue-based, 120

Ethics committees, functions of, 130-131

Evidence-based clinical indicators, 47 Evidence-based medicine

epidemiologic studies, 815-830 medical literature interpretation, 836-837

principles of, 815-839

statistics in reproductive research, 832-836, 835f

systematic reviews of medical evidence, 830-832

Excoriation disorder, 534

Exercise, 258-260

aerobic, 259-260

muscle strengthening, 260

in premenstrual syndrome management, 609

Expert Panel on Blood Cholesterol in Children and Adolescents, of National Health and Nutrition Examination Survey, 444

Expert witness testimony, professional behavior during, 101-102

Exposure Control Plan, of Occupational Safety and Health Administration, 775-776

F

Facilities, 137-146

for ambulatory gynecologic surgery, 114-143, 725-730, 726b-727b, 730b

general requirements, 137-139 inpatient, 144-145

office settings, 142-143 organization and equipment for, 143-144

special physical and supply require­ments, 139-142

surgical, 143-144

Failure mode and effects analysis, in quality improvement in inpatient setting, 50-51

Family history

in genetic risk assessment, 306-307, 306b in medical history, 224-225

in preconception care, 385 Family planning, 343-380. See also

Contraceptives

fertility awareness-based methods in, 365

initial evaluation in, 343, 345-349 contraceptive and sexual history in, 346

contraceptive counseling in, 348-349 laboratory tests in, 347-348 physical examination in, 347-348 screening for reproductive and sexual coercion and intimate partner violence in, 346-347

methods, 351-371

periodic reassessment in, 349-350 in special populations, 350, 351b Family Smoking Prevention and Tobacco Control Act, 325

Fasting lipoprotein profile, 280, 281b Fat(s), solid, intake of, 256-257

FDA. See U.S. Food and Drug Administration

Federal Bureau of Investigation, on rape, 458, 549-550, 551b

Feedback, in quality improvement in inpatient setting, 43

Fellows, admitting privileges of, 24 Female circumcision. See Female genital cutting

Female genital cutting, 493-498 American College of Obstetricians and

Gynecologists on, 495 addressing of, 495-496 complications of, 494-495 forms of, 494 prevalence of, 493 procedure, 494 reasons for, 493-494 specialized care after, 496-497 Female orgasmic disorder, 677, 678t,

680

Female sexual interest/arousal disorder, 677, 678t, 680

Female-to-male transgender individuals barriers to health care for, 505 caring for, 507-508 defined, 506b

Feminist ethics, 120-121

Fertility, in breast cancer patients, 648 Fertility awareness-based methods, in family planning, 365

Fertility preservation, cancer and, 660 Fetal death

early, 707

late, 707 Fiber, dietary, intake of, 253, 255 Fibroids. See Leiomyoma(s) FIGO. See International Federation of

Gynecology and Obstetrics Financial records, medical records versus,

169

Fitness, 245-263. See also specific components; Weight exercise in, 258-260 nutrition in, 250-258 special diets in, 257-258 weight in, 245-250

Fluoxetine, for depression, 561 Focused ultrasound surgery, magnetic resonance imaging-guided, in leiomyoma management, 596-597

Folic acid, intake of, 255

Folic acid supplementation, in preconception care, 382, 389 Follicle-stimulating hormone (FSH), in amenorrhea assessment, 570

Follow-up services, 163-165 ethics in aftercare, 164-165 transition care, 163-164

Food and Agriculture Organization, of United Nations, on probiotics, 266

Fracture(s)

causes of, 295, 296b

in older women, 484-485 prevention of, hormone therapy in, 472

Fracture risk assessment tool (FRAX), in bone mineral density screening, 299-301, 300t

Fraud, billing, 110-111

FRAX. See Fracture risk assessment tool

FSH. See Follicle-stimulating hormone Functional assessment, of older women, 480-483

G

Gabapentin, in menopausal symptom management in breast cancer patients, 646

Gastric bypass, for weight loss, 250

Gastroplasty, for weight loss, 250

GDM. See Gestational diabetes mellitus

General anesthesia

continuum of depth of, 732t defined, 731b

Genetic conditions, red flags for, 305, 306b

Genetic counseling, in preconception care, 391

Genetic Information Nondiscrimination Act of 2008, 307

Genetic risk assessment, 305-309 assisted risk technology in, 307 ethical issues in, 307 family history in, 306-307, 306b in preconception and prenatal screening, 305-306

Genetic Testing Registry, of National Center of Biotechnology Information, of National Institutes of Health, 305

Genital bleeding, abnormal. See Abnormal genital bleeding

Genital mutilation. See Female genital cutting

Genital ulcers, diseases characterized by, 407t-408t

Genital warts, in children, 425-426

Genito-pelvic pain/penetration disorder, 677, 679t, 680-681

Gestational choriocarcinoma, incidence

of, 658

Gestational diabetes mellitus (GDM), 287, 292

Gestational trophoblastic disease, 658-660 contraceptive use and, 660 described, 658-659 future pregnancies and, 660 incidence of, 658

malignant, 659-660

Gloves, in infection control, 148 Gluten-free diet, 258

GnRH. See Gonadotropin-releasing hormone

Gonadotropin-releasing hormone (GnRH) agonists

in endometriosis management, 587-588, 590-591

in leiomyoma management, 594-595 Gonadotropin-releasing hormone (GnRH) antagonists, in leiomyoma manage­ment, 595

Gonorrhea

cervicitis and, 408t-411t

in children, 431

evaluation for, nucleic acid amplifica­tion tests in, 229

urethritis and, 408t-411t

Governance, 3-15

administration and, 1-134

of ambulatory surgical facilities, 12

of Department of Obstetrics and Gynecology, 3-12

of offices, 13

Government regulations

Clinical Laboratory Improvement Amendments, 87, 89-90 compliance with, 87-93 on emergency medical treatment, 87, 90-91

Emergency Medical Treatment and Labor Act, 90-91

Health Insurance Portability Accountability Act, 87, 91

on laboratory testing, 87, 89-90

Mammography Quality Standards Act, 87, 91-92

with most substantial effect, 87

Government regulations (continued) on occupational exposure to bloodborne pathogens, 87-89

Grains, refined, intake of, 257

Gram staining, for Nugent scoring of bac­terial flora, in vaginitis evaluation, 616

G-spot amplification, 680

Gynecologic care, 565-748

Gynecologic Oncology Group, information on, 847

Gynecologic pain, chronic, 623-628. See also specific causes and types

Gynecologic privileges

granting, 757-767

sample application for, 769-772

basis for granting privileges, 770 new, untried, unproven, or experi­mental procedures and treatment modalities and instrumentation, 772

provisional period, 771-772 Gynecologic surgery, ambulatory, 725-748.

See also Ambulatory gynecologic surgery

Gynecologic Survey Society, information on, 847

H

Hand hygiene

Centers for Disease Control and Prevention on, 147-148

defined, 147

in infection control, 147-148

in patient safety, 69-70

Harassment, sexual, 111

HBV. See Hepatitis B virus

HCV. See Hepatitis C virus

Health care, access to, 205-215. See also Access to care

Health care decision making, Patient Self­Determination Act of 1990 on, 519

Health Care Financing Administration, 223 Health care power of attorney, 519-521 Health Care Quality Improvement Act, on peer review, 54

Health Information Technology for Economic and Clinical Health Act, of American Recovery and Reinvestment Act of 2009, 810

Health Insurance Portability and Accountability Act (HIPAA), 87, 91, 807-811

on confidentiality, 98

on medical records, 168-170 privacy of individually identifiable health information of, 809-811, 8111 privacy regulations of, penalties for violating, 810, 811t

Privacy Rule, 170 regulations, on quality improvement, 42 security regulations, 808 transactions and code sets, 807-808

Health literacy, 207-208

“Health Literacy: A Prescription to End Confusion,” 46

Quick Guide to Health Literacy, of the U.S. Department of Health and Human Services, 207-208

Healthcare Failure Mode and Effect Analysis, 51

Healthy People 2020, 47, 394

Hearing disorders, in older women, 483

Heavy menstrual bleeding, defined, 575 HEDIS data. See National Committee for Quality Assurance Healthcare Effectiveness Data and Information Set data

Hepatitis B virus (HBV)

diagnosis and management of, 412-413 immunizations for health care providers against, 106

vaccination against, 781-783

Hepatitis C virus (HCV), immunizations for health care providers against, 106

Herbal supplements, during menopause,

476

Herpes simplex virus (HSV) in children, 426 genital ulcers and, 407t-408t

Heterocyclic agents, for depression, 561 HIPAA. See Health Insurance Portability and Accountability Act

Hirsutism, polycystic ovary syndrome and, 670

HIV infection. See Human immunodefi­ciency virus infection

Homeless women, health care for, 210-212 Honesty, in ethics of care, 125-126

Hormonal contraceptives

combined, 262b-363b, 358-361, 360b in diabetics, 291

Hormone therapy (HT)

American College of Obstetricians and Gynecologists on, 489

in amenorrhea management, 570-571 in breast cancer management, 645 menopausal, 471-475

benefits of, 471-472 combined, 471-474 compounded bioidentical, 474-475 contraindications to, 473-474 estrogen-only, 471-474 risks associated with, 472-473 treatment regimens, 471

in osteoporosis prevention and treat­ment, 302

Hospice care, for terminally ill patients, 522-523

Hospital care, for terminally ill patients, 521-522

Hospitalists, certification and training of, 187-189

HPV. See Human papillomavirus

HSV. See Herpes simplex virus

HT. See Hormone therapy

Human Genome Project, 305

Human immunodeficiency virus (HIV) infection

in adolescents, 455-456

diagnosis and management of, 413-414 in female-to-male transgender individuals, 507

occupational exposure to, management of, 151

screening for confidentiality and, 98 in lesbians and bisexual women, 500

sexual abuse in children and, 546 sexual coercion and, 346-347 sexually transmitted infections and, 399

Human papillomavirus (HPV) infection condyloma acuminata due to, 425-426 diagnosis and management of, 412 immunization against, 238-241, 239b-240b, 388

in adolescents, 446

in sexually transmitted infections prevention, 400-401

Human papillomavirus (HPV) infection

(continued)

prevention of, 400

Human resources, 95-116

described, 95

governing of, 95-96

personnel, 95-96

professional behavior, 96-112

Hydatidiform mole

described, 711

diagnosis of, 659

incidence of, 658

symptoms of, 659

Hyperglycemia, diabetes mellitus and,

287

Hypertension, 275-279. See also Blood pressure

in adolescents, 443-444

classification of, 276, 276t

defined, 275

evaluation of, 277

hormone therapy and, 473 identification of, 277

laboratory assessments for, 277

management of, 277-279

prevalence of, 275

Hypothesis testing, in reproductive research, 832-833

Hysterectomy

informed consent for, 123-124

in leiomyoma management, 593, 597 with or without bilateral oophorectomy, in endometriosis management, 589

in postmenopausal women, pelvic organ prolapse and, 683

Hysteroscopy

in abnormal uterine bleeding evaluation, 579

dilation and curettage with, in abnormal uterine bleeding management, 580

I

Illicit drug use, prevalence of, 329 Imaging services, 160-162

Immigrants, undocumented, health care for, 209-210

Immunization(s), 233-244

adverse events, reporting of, 238 contraindications to, 236-237

Immunization(s)(continued)

hepatitis B virus

in health care providers, 106

Occupational Safety and Health Administration on, 781-783 history of, in preconception care, 385 human papillomavirus, 238-241, 239b-240b, 446

in infectious disease prevention, 105-107

integration into practice, 234-238 in interconception care, 393-394 in older women, 485-486

in preconception care, counseling related to, 388

schedules for, 236

in sexually transmitted infections prevention, 400

vaccine administration, storage, and handling, 236

vaccine information statements, 237-238 Immunization for Women web site, 233 Impaired clinicians, 32-34, 102-104 Impairment, in practitioners' behavior, 32-34, 102-104

intervention steps, 33-34 manifestations of, 32-33

Implant(s), contraceptive, 355-356, 355b Incontinence, urinary, 689-695. See also Urinary incontinence

Induced abortion. See Abortion Infection(s). See specific types

Infection control, 147-156. See also

Bloodborne pathogens

Association for Professionals in Infection Control and Epidemiology, on cleaning and disinfecting equip­ment in infection control, 153 environmental, 153-154 equipment cleaning and disinfecting in, 152-153, 153b

hand hygiene in, 147-148 isolation in, 148-150

postexposure testing and prophylaxis in, 150-151

standard precautions in, 148-150 Infection control programs, in patient safety, 70

Infectious diseases, prevention of, profes­sional behavior in, 104-107

Infectious Diseases Society for Obstetrics and Gynecology, information on, 847

Infertility, 703-706 causes of, 703 emotional and educational needs and

demands of patients with, 703-704 prevalence of, 703 smoking and, 331 sexually transmitted infections and, 399 supporting services for couples with, 704 in women of advanced reproductive age,

381-382

Infibulation, 494 Influenza, immunizations for health care

providers against, 106

Information management, 167-183 electronic health records, 170-172 informed consent, 179-181 medical records, 167-170 in patient communication, 172-179,

178b

Informed consent. See also Consent autonomy in, 122, 124 communication in, 122 documentation of, 179-181 ethical issues in, 121-124 in health care quality and safety, 122 for hysterectomy, 123-124 as process, 123 for sterilization, 123-124 “substituted judgment” for, 122-123 for women with disabilities, 514 Injectable contraceptive formulations, 356-358

Inpatient facilities, 144-145

Inpatient setting, quality improvement in,

40-57. See also Quality improvement Institute of Medicine

on communication in patient safety, 71 on dietary needs during menopause,

470

on quality improvement, 39

on quality indicators, 46

on sexually transmitted infections, 399 Institutional ethics committees, 129-131 Institutional review board (IRB), 11 Insulin resistance, diabetes mellitus type 2 due to, 287

Interconception care, 392-395 counseling in, 394-395 described, 392

immunizations in, 393-394 interval history in, 393 physical assessment in, 393 postpartum visit in, 392-395 screening and testing in, 393-394 transition to well-woman care, 395 International Federation of Gynecology and Obstetrics (FIGO) in cervical cancer staging, 650 on classification system for abnormal uterine bleeding, 576-577, 576f Intersex, defined, 506b

Intervention, motivational, in substance abuse management, 337

Interview, medical history, in annual health assessment, 219-222, 220b, 222b

Intimate partner violence. See Violence Intraoperative care, in ambulatory gynecologic surgery, 740-741

Intrauterine devices (IUDs), 352-355, 355b candidates for, 353

contraindications to, 352-353 copper, 354

examination before use of, 353-354 follow-up examination, 354 gestational trophoblastic disease and, 660

insertion timing, 354, 355b levonorgestrel, 354 pelvic inflammatory disease related to, 353

prevalence of use, 352 types of, 354

IRB. See Institutional review board

Iron, intake of, 255-256

Irritant vulvovaginitis, 620 Isolation, in infection control, 148-150 Itinerant surgeons, privileges of, 26 IUDs. See Intrauterine devices

J

Jacobs Institute of Women's Health, information on, 848

Joint Commission. See The Joint Commission

Justice, defined, 119

K

Korotkoff heart sounds in blood pressure measurement, 277

L

Labial adhesions, in children, 426-427 Labor-inducing abortion, 718, 719 Laboratory certificates, 90

Laboratory services, 159-160

Laboratory testing, government regulations for, 87, 89-90

Lactose intolerance, diet for people with, 258

Laparoscopy, in endometriosis management, 588, 590

Late fetal death, 707

Latex allergy, 140-141

Latex condoms, 401-402, 401b

Latex sensitivity, 140-141

Latex sheets, in sexually transmitted infections prevention, 415 Leadership, in quality improvement in inpatient setting, 41

Legal issues

confidentiality in adolescent health care, 439-441

induced abortion-related, 717-718 of lesbians and bisexual women, 501

Legal rights, in end-of-life considerations, 519-521

Leiomyoma(s), 593-598

Abnormal uterine bleeding, 577 benign nature of, 594 costs related to, 593 diagnosis of, 593

management of, 593-597

medical interventions in, 594-595 surgical, 595-597

in postmenopausal women, 594 prevalence of, 593

uterine, symptomatic, 577

LEP. See Limited English proficiency Lesbians, 499-503

barriers to health care for, 499 diversity among, 499 legal issues related to, 501 psychosocial concerns of, 500-501 routine health visits for, 500 welcoming patient care environment for, 501-502

Levonorgestrel, in emergency contraception, 366, 368t

Lichen planus, 632

Lichen sclerosus, 427, 631-632

Lifestyle modifications

in amenorrhea management, 571

in hypertension prevention and manage­ment, 278-279

in menopausal symptom management in breast cancer patients, 647 during menopause, 476

in premenstrual syndrome management, 609

Limited English proficiency (LEP), prohibitions of discrimination against persons with, 805-806

Lipid disorders. See Dyslipidemia Lipoprotein profile, fasting, 280, 281b Litigation stress, risk management associated with, 84

Living will, 519-521

Lumpectomy, in breast cancer management, 644

Lung cancer

deaths due to, 324

National Cancer Institute on screening for, 324-325

Lynch syndrome, ovarian cancer and,

323

M

Magnetic resonance imaging (MRI)

in abnormal uterine bleeding evaluation, 579

in breast cancer screening, 316, 317 Magnetic resonance imaging-guided focused ultrasound surgery, in leiomyoma management, 596-597

Major depressive disorders, diagnostic criteria for, 557b-558b

Male-to-female transgender individuals caring for, 508

defined, 506b

Mammography

in breast cancer screening, 314-315, 318, 643

in breast cancer diagnosis, 318

facilities and equipment, 143 government regulations for, 87, 91-92

Mammography (continued)

National Cancer Institute Information

Service, in mammography screening, 91-92

Mammography Quality Standards Act

(MQSA), 87, 91-92, 315 Manipulative and body-based practices,

267

Mastectomy, in breast cancer management,

644

Masters, Johnson, and Kaplan, sexual response cycle of, 673, 673f

Maternal age, counseling related to, in preconception care, 390-391 Measures of association, in reproductive health research, 834, 836

Medical abortion, 718-719

Medical director, 13

Medical history in annual health assess­ment, 219-225, 220b, 222b chief complaint, 223 conducting the interview, 219-222, 220b, 222b

content of, 222-225 history of present illness in, 224 past, family, and social history in, 224-225

review of systems in, 224

Medical office practices, governance of,

13

Medical orders for life-sustaining treatment, 126

Medical records

access to, 168 confidentiality of, 168-169 content of, 167 erroneous entries in, 168 financial records versus, 169 Health Insurance Portability and

Accountability Act on, 168-170 management of, 167-170 organization of, 168 requests for, 169 retaining of, 169 surgical notations in, 167

Medical specialty board certification, 19 Medical staff appointments, credentialing and, 17-21, 19b, 21b

Medicare and Medicaid EHR Incentive

Programs, 170

Medication(s). See also Drugs; Prescription drug(s); specific types control and disposal of, in practice management, 197-198 for depression, 560-561 history of, in preconception care, 385 during menopause, 475-476 in older women, issues related to, 487-489

in premenstrual syndrome management, 609-610

in preconception care, counseling related to, 390

Medication errors, prevention of, 65-66, 66t

MedWatch, of the U.S. Food and Drug Administration, 157-158

Meeting(s), of Department of Obstetrics and Gynecology, 9

Menopausal symptoms, in breast cancer patients, 646-647

Menopause, 469-478 counseling related to, 470 defined, 469 dietary needs during, 470 early, smoking and, 331 hormone therapy during, 471-475 median age of, 469 nonhormonal therapy options during, 475-477

complementary and alternative therapies, 476

lifestyle and behavioral modifications,

476

pharmacologic agents, 475-476 vaginal lubricants and moisturizers,

477

premature, 469 symptoms of, 469

Menorrhagia. See Menstrual bleeding, heavy

Menstrual bleeding, heavy, defined, 575 Menstrual cycles

heavy bleeding in, 575 irregular, anorexia nervosa and, 528 normal, 567

in young females, 436b

Menstrual disorders

in adolescents, evaluation required for, 437b, 443

Menstrual disorders (continued) polycystic ovary syndrome and, 669-670

Menstrual history, in adolescents, evaluation of, 437b, 443

Menstrual issues, in adolescents with disabilities, 461-462

Menstrual suppression, in women with disabilities, 515

Mental status, in older women, 481-482

Meta-analysis, of medical evidence, 830

Metrorrhagia. See Abnormal uterine bleeding

Metabolic syndrome, 274 defined, 274 management of, 274-275

Microscopy, provider-performed. See Provider-performed microscopy

Midwives, certification and training of, 192-193

Military, women in, health care for, 212-213

Mind-body practices, 265

Minor(s). See also Adolescent(s); Primary and preventive care confidentiality-related rights of, 99, 438-441, 442t

health care for, legal considerations related to, 439-441

Miscarriage. See Pregnancy loss

Molar pregnancy, 711

Molluscum contagiosum, in children, 425

Monoamine oxidase inhibitors, for depression, 561

Mood disorders, prevalence of, 555. See also Depression

Motivational intervention, in substance abuse management, 337

Motor vehicle accidents, adolescents and, 451

MQSA. See Mammography Quality Standards Act

MRI. See Magnetic resonance imaging

Muscle strengthening, 260

Myomectomy, in leiomyoma management, 595-596

N

NAATs. See Nucleic amplification tests NAMS. See North American Menopause Society

National Cancer Institute

on breast cancer risk, 319 on lung cancer screening, 324-325 National Center of Biotechnology

Information, of National Institutes of Health, Genetic Testing Registry, 305

National Certification Corporation, 20, 190 National Committee for Quality Assurance Healthcare Effectiveness Data and Information Set (HEDIS) data, 47

National Comprehensive Cancer Network, on breast self-awareness, 226

National Guideline Clearinghouse, 217 National Heart, Lung, and Blood Institute, of National Institutes of Health

on body mass index, 245

Expert Panel on Blood Cholesterol in Children and Adolescents of, 444 on metabolic syndrome, 274

National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents of, 443

Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure of, 276, 276t National Institute on Drug Abuse, “Drug Use Screening Tool” of, 335 National Osteoporosis Foundation, on fracture risk assessment tool FRAX, 301

National Patient Safety Goals, 63, 70, 224, 487

National Practitioner Data Bank (NPDB), 18, 19b

on granting gynecologic privileges, 757 on quality improvement in inpatient setting, 57

Natural membrane condoms, 401-402 Naturopathic physician (ND), certification and training of, 193

ND. See Naturopathic physician Needlestick Safety and Prevention Act, 88-89 Neuromodulation, in pain management,

602

Neurostimulation, in pain management,

603

Nidation, defined, 717

Noncoital sexual activity among adolescents, 456 sexual health risks related to, 414-415

Noncompliance, 519

Nonmaleficence, defined, 118 Nonsteroidal antiinflammatory drugs (NSAIDs)

oral contraceptives with, in endometrio­sis management, 587, 590

in pain management, 602

Nonsuicidal self-injury behavior disorder, 534

North American Menopause Society (NAMS), 469, 848

North American Registry of Midwives, 192-193

North American Society for Pediatric and Adolescent Gynecology, informa­tion on, 848

North American Society for Psychosocial Obstetrics and Gynecology, infor­mation on, 848-849

Notice of Privacy Practices, on medical records, 169

NPDB. See National Practitioner Data Bank

NPs. See Nurse practitioners

NSAIDs. See Nonsteroidal antiinflamma­tory drugs

Nucleic acid amplification tests (NAATs), in gonorrhea and chlamydial infection detection, 229

Nugent scoring of bacterial flora, Gram staining for, in vaginitis evaluation, 616

Nurse practitioners (NPs) certification and training of, 20, 190 clinical privileges of, 24

Nutrition, 250-258

foods and food components to reduce, 254b, 256-258

foods and nutrients to increase, 251b-253b, 253, 255-256 importance of, 250-251 in preconception care, counseling related to, 388-389

Nutritional deficiencies, in older women, 486

Nutritional status, in preconception care, 385-386

O

Obesity

among adolescents, 444-445 management of, guidelines for, 245-246, 249, 250

polycystic ovary syndrome and, 669 Observational studies, 816, 822-830 analytical, 817, 817f case-control studies, 824-826, 825f cohort studies, 822-824, 822b, 824f cross-sectional studies, 826-829, 827f, 829f

descriptive studies, 829-830 Obstetrician-gynecologists

certification and training of, 186-187 ratio per women, 206

Occupational exposure

to bloodborne pathogens, Occupational Safety and Health Administration regulations on, 87-89, 773-786 to human immunodeficiency virus, management of, 151

Occupational Safety and Health Administration (OSHA) on occupational exposure to bloodborne pathogens, 87-89, 773-786 approved state plans, 774-775 communications of hazards to employees, 783-785 engineering and work practice controls, 776-778

Exposure Control Plan, 775-776 hepatitis B virus immunization, 781-783

housekeeping, 779-781 mandatory universal precautions, 776 personal protective equipment, 778-779

record-keeping requirements, 785-786 regulations, 775-786

“sharps injury log,” 786 on surgical facilities, 144

OCR. See Office for Civil Rights

Office(s)

closure of, risk management associated with, 83

facilities and equipment, 142-143 governance of, 13

quality improvement in, 57-61, 58b-60b

Office for Civil Rights (OCR), of U.S. Department of Health and Human Services, 805-806

Office of Disease Prevention and Health Promotion of U.S. Department of Health and Human Services, 207-208

Office of Minority Health, of U.S. Department of Health and Human Services, 72

Office of the Inspector General, on credentialing, 18

Office setting

ambulatory gynecologic surgery in, regulations for, 725-726, 726b-728b

confidentiality in health care for adolescents in, 438-441, 442t Office staff, regular meetings for, 13 “Office Surgical Safety Checklist,” of American College of Obstetricians and Gynecologists, 738, 739b-740b Older women. See Women 65 years and older

Oligomenorrhea. See Abnormal uterine bleeding

Oophorectomy, bilateral, in endometriosis management, 589

Opioid(s)

abuse of, prevention of, 338

in pain management, 602

Oral contraceptives, 359-361, 360b

access to, 361

costs of, 361

in emergency contraception, 366-371, 368t-370t

gestational trophoblastic disease and, 660 missed doses, 359-361, 360b nonsteroidal antiinflammatory drugs with, in endometriosis management, 587, 590

Oral sex

among adolescents, 456

barrier contraception during, 415 Oral-genital sex, health risks associated with, 414-415

OSHA. See Occupational Safety and Health Administration

Ospemifene, for dyspareunia in postmenopausal women, 633

Osteoporosis, 295-304 amenorrhea and, 571 bone mineral density screening for, 297-299, 298f, 300b, 300t in breast cancer patients, 645-646 causes of, 295, 296b defined, 295 in older women, 484-485 pharmacologic interventions for, 301-302

postmenopausal, risk factors for, 295 prevention of

counseling in, 297 hormone therapy in, 472

Outcomes measures, performance measures versus, 49

Ovarian cancer, 654-656 deaths due to, 322, 654, 656-657 evaluation and diagnosis of, 655-656 5-year survival rate, 654 hormone therapy and, 472 Lynch syndrome and, 323 management of, 656 pathogenesis of, 654 prevalence of, 654 screening for, 322-323

Ovulatory dysfunction, abnormal uterine bleeding due to, 577

P

Pain

pelvic, chronic, 627 postoperative, prevalence of, 599

Pain management, 599-605 acute, 599-605 approaches to, 601-603 chronic, 599-605 guidelines and quality indicators in, 599-601, 600b

legislation and regulations related to, 603 neuromodulation in, 602 neurostimulation in, 603

nonsteroidal antiinflammatory drugs in, 602

opioids in, 602

for terminally ill patients, 523

Pain scales, in pain management, 602 Painkillers, deaths due to, 334 PALM-COEIN classification system, 576-577, 576f

Pap tests, in cervical cancer screening, 321 Parathyroid hormone, in osteoporosis prevention and treatment, 302 Paroxetine, during menopause, 475-476 PAs. See Physician assistants Patent(s), conflict of interest related to, 108

Paternalism, defined, 119

Pathology services, 159-160 Patient-clinician relationship, in ethical decision making, 130

Patient communication

electronic, 177-179, 178b guidelines for, 178b patient confidentiality and, 177-179, 178b, 180b

risks associated with, 177 social media dos and don'ts, 179, 180b management of, 172-179 missed appointments, 175-177 remote consultations, 179 RESPECT communication model, 220b test results notification, 175 tracking and reminder systems in, 173-177

Patient handoffs, communication in, patient safety-related, 74

Patient information, confidentiality of, 97-99

Patient protection, ethical issues in, 126-129

Patient Protection and Affordable Care Act (ACA), 87, 128, 205-206, 211

Patient referral. See Referral(s)

Patient safety, 63-77

American College of Obstetricians and Gynecologists on, 63-64

after intimate partner violence, 541 communication in, 70-74

with coordination of care, 74 cultural sensitivity and awareness in, 72-73

with health care providers, 73 with patient handoffs, 74 culture of, development of, 64-65, 64b in every aspect of practice, 74 facilities and equipment-related, 139 hand hygiene in, 69-70 informed consent in, 122 medication practices in, 65-66, 66t

Patient safety (continued)

National Patient Safety Goals, 63, 70, 224, 487

principles of, 63-74

“Report of the Presidential Task Force on Patient Safety in the Office Setting,” of the American College of Obstetricians and Gynecologists, 143, 738, 739b-740b

surgical errors reduction in, 67-69, 68f Patient Safety program, of World Health Organization, 738

Patient Self-Determination Act of 1990, 519

Patient-physician relationship

code of conduct for, 751-752 ethical foundation for, 749-750

Patient's bill of rights, purpose of, 127-128 PCOS. See Polycystic ovary syndrome Pediatric gynecology, 421-433

examination procedures, 421-422, 422f precocious puberty, 427-430,

428b-429b

sexual abuse, 430-431 vulvar disorders, 425-427 vulvovaginitis, 423-425

Peer review

Health Care Quality Improvement Act on, 54

in quality improvement in inpatient setting, 54-55, 55b

Pelvic examination, in annual health assessment, 218, 227-229 bimanual examination, 229 external examination, 228 speculum examination, 228-229

Pelvic inflammatory disease (PID) diagnosis of, 406, 411-412, 411b intrauterine devices and, 353 treatment of, 406, 411-412, 411b

Pelvic organ prolapse, 683-687

described, 683

evaluation and diagnosis of, 684 management of, 683-685

prevalence of, 683

risk factors for, 683-684

Pelvic Organ Prolapse Quantification system, 684

Pelvic pain, chronic, 627

Performance measurement, data for, 50

Performance measures

design of, 49 outcomes measures versus, 49 in quality improvement in inpatient setting, 48-50

types of, 49

Personnel management. See Human resources

Pessary use, in pelvic organ prolapse management, 685

Pharmaceutical samples, conflict of interest related to, 109-110

Pharmacy compounding law, 158-159 Pharmacy services, 157-159

Physical abuse, of children, 545

Physical activity

caloric needs related to, 247-249, 248t in premenstrual syndrome management, 609

recommended, 258-260

Physical conduct and practice, ethical foundation for, 750

Physical examination

in annual health assessment, 218, 225-226

chaperone during, 100

in initial evaluation in family planning, 347-348

in interconception care, 393

Physician assistants (PAs). See also Staffing certification and training of, 20, 191 clinical privileges of, 24-25

Physician behavior

code of conduct for, 752-753

risk management associated with, 84

Physician orders for life-sustaining treatment (POLST), 126

Physician reentry, defined, 28 Phytoestrogens, during menopause, 476 PID. See Pelvic inflammatory disease PMDD. See Premenstrual dysphoric disorder PMS. See Premenstrual syndrome

POLST. See Physician orders for life-sustaining treatment

Polycystic ovary syndrome (PCOS), 665-671

amenorrhea due to, 567, 568t, 569t Androgen Excess Society, diagnostic criteria for, 665, 666t cardiovascular disease risk with, 669

Polycystic ovary syndrome (continued)

defined, 665

diabetes and, 669

diagnostic criteria for, 665-666, 666t, 667b-668b

differential diagnosis of, 667b evaluation for, 665-666, 667b-668b hirsutism and, 670

management of, 669-670 menstrual disorders and, 669-670

National Institutes of Health, diagnostic criteria for, 665, 666t

obesity and, 669

Rotterdam PCOS Consensus Workshop Group, diagnostic criteria for, 665, 666t

Polymenorrhea. See Abnormal uterine bleeding

Polymerase chain reaction tests, for Trichomonas spp., in vaginitis evaluation, 616

Polyurethane condoms, 401, 402 POP-Q. See Pelvic Organ Prolapse

Quantification system Posthumous reproduction, 523-524 Postmenopausal women

dyspareunia in, management of, 633 hysterectomy in, pelvic organ prolapse and, 683

leiomyomas in, 594 tamoxifen in, 645 urinary tract infections in, versus pre­menopausal women, 697, 698b Postoperative care, ambulatory gynecologic surgery and, 741-742 Postoperative pain, prevalence of, 599 Postpartum contraception. See

Contraceptive(s)

Postpartum period, depression during, 394 Postpartum visit, in interconception care, 392-395

Power of attorney, health care, 519-521 PPM. See Provider-performed microscopy Practice coverage, 81-82, 197

Practice management, 185-200

appointments, scheduling, and patient flow in, 196-197 ambulatory care, 196 operating room data and data tracking, 196-197

Practice management (continued) billing and coding practices in,

193-195, 194b

care coordination in, 195 drug control and disposal in, 197-198 practice coverage in, 197 staffing in, 185-195

Precocious puberty, 427-430, 428b-429b.

See also Puberty, precocious benign variants of, 430 causes of, 428, 428b-429b classification of, 428, 428b-429b diagnostic studies of, 429-430 Lawson Wilkins Pediatric Endocrine

Society guidelines on, 427 Preconception care, 381-392 blood glucose control in, 382-383 contraceptive planning in, 382 counseling in, 382, 387-392 folic acid supplementation in, 382 genetic risk assessment in, 305-306 patient history in, 383-386, 384b environmental factors, 386, 387b family history, 385 immunization history, 385 medical history, 383, 384b medication and substance use and abuse, 385

nutritional status, 385-386 reproductive history, 385 physical assessment in, 386 reproductive health plan in, 381 screening and testing in, 386 Pregnancy

in adolescents

prevalence of, 454-455 risk factors for, 454-456 unintended pregnancy, 456 early complications of, 707-712 ectopic, 709-711. See also Ectopic pregnancy

Emergency Medical Treatment and Labor Act requirements during, 794-795

how to be reasonably certain that a woman is not pregnant, 355b molar, 711

Pregnancy loss early, 707-709

causes of, 707-708

Pregnancy loss, early (continued)

complications of, 708 defined, 707 diagnosis of, 708 management of, 708-709 prevalence of, 708 risk factors for, 708

recurrent, 713-716

Premature menopause, 469

Premenstrual dysphoric disorder (PMDD), 608, 610, 611b-612b

defined, 610

diagnostic criteria for, 610, 611b-612b fluoxetine for, 561

Premenstrual syndrome (PMS), 607-613 causes of, 607 defined, 607 evaluation and diagnosis of, 607-608, 608b

management of, 609-610 prevalence of, 607

Prenatal screening, genetic risk assessment in, 305-306

Prepubertal child, gynecologic examination of, 421-422, 422f

Prescription drug(s). See also Drug(s);

Medication(s) abuse of, 329, 338 nonmedical use of, deaths due to, 334

Prescription Drug Marketing Act of 1987, 158

President’s Advisory Commission on Consumer Protection and Quality in the Health Care Industry, 128

Primary and preventive care, 201-563.

See also specific components;

Adolescent(s); Minor(s) abuse, 537-553 access to care, 205-215 adolescents, 435-467 annual health assessment, 217-231 bisexual women, 499-503 complementary and alternative medicine, 265-271

cancer screening and prevention, 311-328

cardiovascular disorders, 273-285 depression, 555-563 diabetes mellitus, 287-293 end-of-life considerations, 517-526

Primary and preventive care (continued) family planning, 343-380 female genital cutting, 493-498 fitness, 245-263

genetic risk assessment, 305-309 immunizations, 233-244 lesbians, 499-503 menopause, 469-478 osteoporosis, 295-304 pediatric gynecology, 421-433 preconception and interconception care, 381-392

psychosocial issues, 527-536 scope of, 202b-203b

sexually transmitted infections, 399-419

substance use and abuse, 329-341 transgender individuals, 505-510 transition to, 395

U.S. organizations concerned with, 841-850

women 65 years and older, 479-491 women with disabilities, 511-516

Principle-based ethics, 118-120 Privilege(s)

added skills or qualifications for, 26-28

admitting, 24

after period of inactivity, 28-30 blanket approval for, 23

of certified nurse-midwives, nurse prac­titioners, and physician assistants, 24-25

core, 23-24

delineation of, 22-30 described, 757-758 differentiation of, 23

granting, 22-30, 757-767 certification and, 759 training and, 759

of itinerant surgeons, 26 levels of, 24 provisional status, 25-26 requests for new, 766-767 revoking, 35-36 temporary, 25

Privileging, described, 757-758 Probiotics, defined, 266

Process indicators, 46-47

Process measurements, 49

Professional behavior, 96-112

billing fraud, 110-111

chaperones and, 100

Code of Professional Ethics of the American College of Obstetricians and Gynecologists, 97

confidentiality, 97-99

conflict of interest, 107-110

expert witness testimony, 101-102 impaired clinicians, 102-104 in infectious disease prevention, 104-107 Centers for Disease Control and

Prevention on, 104 immunizations, 105-107 preventive measures, 107 institutional policies and procedures regarding, 96-97

referrals, 100-101

sexual harassment, 111

sexual misconduct, 111-112

Professional relations

code of conduct for, 754

ethical foundation for, 750 Progesterone modulators, in leiomyoma management, 595 Progesterone-only contraceptives, in diabetics, 291

Progestin-only pills, 363-364, 366 Provider-performed microscopy (PPM), certificate for, from Clinical Laboratory Improvement Amendments, 788-790

Provisional status privileges, 25-26 Pruritus, vulvar. See Vulvar pruritus Psychiatric illness, counseling related to, in preconception care, 392

Psychosocial issues, 527-536

feeding and eating disorders, 528-533 in lesbians and bisexual women, 500-501

nonsuicidal self-injury behavior disorder, 534

in older women, 486-487

stress, 527

Psychotherapy, for depression, 560 Pubertal progress, evaluation of, 443 Puberty, precocious, 427-430, 428b-429b.

See also Precocious puberty

Public accommodations, under Americans with Disabilities Act, 801

Public Health Service

on adolescent smokers, 447-448

on management of occupational expo­sures to human immunodeficiency virus, 151

Pyelonephritis, management of, 699

Q

Qualified individual with disability, defined, 800

Quality care, focus of, 40

Quality improvement, 39-62

clinical improvement strategies in, 40f department chair's responsibility in, 5 elements in, 39 focus points in, 40 goal in, 39, 40f

in inpatient setting, 40-57 communication, 42-44 correcting deficiency, 55-57 data collection and analysis, 52-53 department meetings, 42-44 feedback, 43 leadership, 41 peer review, 54-55, 55b quality improvement committee, 41-42 quality measurement, 44-50, 45b quality measurement tools, 50-52 reducing variation, 44

Institute of Medicine on, 39 meetings concerning, 9 in the office, 57-61, 58b-60b challenges related to, 60-61 monitoring systems, 57-59, 58b-59b Safety Certification in Outpatient Practice Excellence program of the American Congress of Obstetricians and Gynecologists, 59, 60b

premise of, 39

Quality improvement committee, in quality improvement in inpatient setting, 41-42

Quality indicators defined, 47-48 evidence-based clinical, development of, 47

focus of, 46-47 function of, 46 gynecologic, examples of, 44-48, 45b Institute of Medicine on, 46

Quality indicators (continued)

monitoring by, 47

process indicators, 46-47 purpose of, 46

in quality improvement in inpatient setting, 44-48, 45b

Quality measurement, 41, 44-50, 45b. See also Quality measurement tools performance measures, 48-50 quality indicators, 44-48, 45b. See also Quality indicators

Quality measurement tools, in quality improvement in inpatient setting, 50-52

failure mode and effects analysis, 50-51 root cause analysis, 51-52

Quality National Healthcare Quality Report, 47

R

RADAR model of physician’s approach to domestic violence, 540b

Radiation monitoring devices, 161

Radiation therapy, in breast cancer management, 645

Randomized clinical trials, 817f, 818-821, 820t

RANK ligand inhibitor, in osteoporosis prevention and treatment, 302

Rape, 549-550, 551b

among adolescents, 458

defined, 458

evaluation of victims, health care providers’ role in, 550, 551b prevalence of, 550

Reasonable accommodations, under Americans with Disabilities Act, 800-801

Reasoning, case-based, 121 Recredentialing, requirements, 18-19 Recurrent pregnancy loss, 713-716 counseling related to, 714-715 defined, 713

evaluation of, 713-714

prevalence of, 713

Referral(s)

described, 82

in endometriosis management, 589 professional behavior for, 100-101 reluctance related to, 82

Referral(s) (continued) responsibilities for, 82-83 in substance abuse treatment, 337 Reflexology, during menopause, 476 Registered nurses, certification and training of, 187

Reminder systems, in patient communication, 173-177

Remote consultations, 179 Reproduction, posthumous, 523-524 Reproductive coercion, 548-549

among adolescents, 457 screening for, 346-347

Reproductive health plan, in preconception care, 381

Reproductive health research errors in, types of, 832-833 statistics in, 832-836, 835f

hypothesis testing and types of error, 832-833

measures of association, 834, 836 probability values compared with point estimates and confidence interval estimation, 833-834, 835f Research programs, in Department of Obstetrics and Gynecology, 9-12 adolescent participants, 11-12 institutional review board in, 11 recruitment of participants, 11 Residency Review Committee for Obstetrics and Gynecology, 11

Retirement, risk management associated with, 83

Retrograde menstruation theory, 583 Risk management, 79-85

adverse events-related, 84 billing-related, 83-84 described, 79 goal of, 79

litigation stress-related, 84 office closure-related, 83 physician behavior-related, 84 practice coverage-related, 81-82 program elements, 79-81 purpose of, 79 referrals-related, 82-83 risk reduction in, 79-81

Root cause analysis, in quality improve­ment in inpatient setting, 51-52 Roux-en-Y procedure, for weight loss, 250

S

“Safe Surgery Saves Lives,” of World Health Organization, 738

Safety, patient. See Patient safety

Safety Certification in Outpatient Practice Excellence program, of American Congress of Obstetricians and Gynecologists, 59, 60b

Safety Information and Adverse Event Reporting Program, of U.S. Food and Drug Administration, 157-158

Sarcoma(s), uterine, 651

Sedation

anesthesia for, 731b continuum of depth of, 732t intraoperative care during, 734-735

Selective estrogen receptor modulators, in osteoporosis prevention and treatment, 301-302

Selective serotonin reuptake inhibitors (SSRIs)

for depression, 560-561

in menopausal symptom management in breast cancer patients, 646 during menopause, 475-476

Self-examination, in breast cancer screening, 316

Sentinel Event Alerts, 63 Serotonin-norepinephrine reuptake inhibitors (SNRIs) in menopausal symptom management in breast cancer patients, 646 during menopause, 475-476

Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, of National Heart, Lung, and Blood Institute, 276, 276t

Sexual abstinence, in adolescents, 453

Sexual abuse. See Abuse

Sexual activity

among adolescents, 455

noncoital, sexual health risks related to, 414-415

Sexual assault, 549-550, 551b among adolescents, 458-459 evaluation of victims, health care providers' role in, 550, 551b screening for, 550

Sexual coercion, 548-549 among adolescents, 457 screening for, 346-347

Sexual dysfunction. See also Sexual function

female, 675-681, 678t-679t adverse effect of, 675 causes of, 675-676 classification of, 677-678 diagnosis of, 678 evaluation of, 676-677 management of, 679-681 types of, 677-678, 678t-679t in older women, 486-487 stress related to, 527

Sexual function, 648, 673-674, 673f, 674f. See also Sexual dysfunction

Sexual harassment, 111

Sexual health risks, noncoital sexual activity and, 414-415

Sexual history

in family planning, 346 questions related to, 222b

Sexual identity, in adolescents, 452

Sexual misconduct, 111-112

Sexual response, female, nonlinear model of, 674, 674f

Sexual response cycle, of Masters, Johnson, and Kaplan, 673, 673f

Sexuality, adolescents and, 452-459 Sexuality education, for adolescents,

452- 454

Sexually transmitted diseases. See Sexually transmitted infections

Sexually transmitted infections (STIs), 399-419. See also specific types in adolescents, 436-437, 445-446 chlamydial infection, 455 human immunodeficiency virus infection, 455-456 risk factors for, 455-456 screening for, 443 sexuality education programs on,

453- 454

diagnosis of, 406-414, 407t-411t, 411b

human immunodeficiency virus infection due to, 399

infertility due to, 399 pelvic examination for, 228-229

Sexually transmitted infections (STIs) (continued)

prevention of, 399-403, 401b immunizations in, 400-401 treatment in, 402-403

screening for, 403-406, 404b-405b in lesbians and bisexual women, 500 in transgender individuals, 507

sexual abuse in children and, 431, 546 sexual coercion and, 346-347 transmission of, 399, 414-415 treatment of, 406, 411-414

SHEA. See Society for Healthcare

Epidemiology of America

Single-use medical devices, reprocessing of, 141-142

Skin disorders. See specific types; Vulvar skin disorders

Smoking, 330-334

adolescents and, 331, 447-448 cessation of

interventions in, 330-332, 330b pharmacotherapy in, 332-334, 333t telephone counseling in, 332 weight gain due to, 332

women versus men, 332

health risks associated with, 331 prevalence of, 329

screening and assessment for, 330-332, 330b

SNRIs. See Serotonin-norepinephrine reuptake inhibitors

Social history, in medical history, 224-225 Social media, dos and don'ts, 179, 180b Societal responsibilities

code of conduct for, 754-755

ethical foundation for, 750-751

Society for Academic Specialists in General Obstetrics and Gynecology, information on, 849

Society for Gynecologic Investigation, information on, 849

Society for Healthcare Epidemiology of America (SHEA), on management of infected health care professionals, 151-152

Society for Maternal-Fetal Medicine, information on, 850

Society of Family Planning, information on, 849

Society of Gynecologic Oncology on endometrial cancer, 653 information on, 850

Society of Gynecologic Surgeons, information on, 850

Sodium, intake of, 256

Solid fats, intake of, 256-257 Sonohysterography, in abnormal uterine bleeding evaluation, 578

Special diets, 257-258

Speculum examination, in annual health assessment, 228-229

Spermicides, contraceptive, 364 Sponge(s), contraceptive, 364 Spontaneous abortion, 707-709 SSRIs. See Selective serotonin reuptake inhibitors

Staffing, 185-195. See also Physician assistants; specific positions for ambulatory gynecologic surgery in office setting, 727b clinical nurse specialists, 189 certified midwives, 189 certified nurse-midwives, 189 guidelines for, 185-186 hospitalists, 187-189 levels of, 185-186 midwives, 192-193 naturopathic physician, 193 nurse practitioner, 190 obstetrician-gynecologists, 186-187 physician assistants, 191 registered nurses, 187 surgical assistants, 191-192 women's health nurse practitioner, 190

Standing committees, 8 Stereotypic self-injury behavior, 534 Sterilization

contraceptive, 351-352 informed consent for, 123-124 surgical, 351-352 vasectomy, 351

Steroid(s), contraceptive, in leiomyoma management, 594

STIs. See Sexually transmitted infections Stress

causes of, 527

litigation, risk management associated with, 84

Stress-reduction techniques, 527

Substance abuse, 329-341. See also specific types

in adolescents, 448-449

alcohol abuse, 334-338

counseling related to, in preconception care, 391

detection of, 329

drug abuse, 334-338

history of, in preconception care, 385 intervention for, 337

prescription drug abuse, prevention of, 338

screening and assessment for, 329-330, 335-337, 336t

smoking, 330-334

treatment of, referral for, 337 Substance/medication-induced sexual dysfunction, 677, 679t, 681 Suction curettage, 718 Sugar, intake of, 256-257

Suicide

in adolescents, 449-451

assessment of 450b

intimate partner violence and, 542

risk factors for, 450b

Surgical assistants, certification and training of, 191-192

Surgical errors, reduction of, in patient safety, 67-69, 68f

Surgical facilities, 143-144

Surgical Safety Checklist, of World Health Organization, 67, 68f, 70, 738

Syphilis, genital ulcers and, 407t-408t

T

T-score, 299, 300t

Tamoxifen

in breast cancer management, 645

during menopause, 475-476

in postmenopausal women, 645 Tampons, proper use of, 443 Tanner staging, 443

Tattoos, in adolescents, 449

Tdap vaccine. See Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine

Telephone counseling, in smoking cessation, 332

Temporary privileges, 25

Teratogen, information sources on, 386, 387b

Testimony, expert witness, professional behavior during, 101-102 Testosterone therapy, in female-to-male transgender individuals, 507-508 Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine, 388, 393

The American College of Obstetricians and Gynecologists

on access to care, 205-207

on ambulatory gynecologic surgery, 728-729

on annual health assessment, 21 on bone mineral density screening, 297-299, 298f

on breast cancer, 312-314, 313t, 317 on breast self-awareness, 226 on cancer screening in women with disabilities, 514

on cervical cytology screening, 442-443 on classification system for abnormal uterine bleeding, 576, 576f

Code of Professional Ethics of, 73, 97, 749-755

on colorectal cancer screening, 324 on diabetes, 289

on dyslipidemia, 279-280, 281b

on elder abuse, 543

on endometrial cancer, 653

on genital cutting, 495

on health care for the uninsured, 208-209

on human papillomavirus vaccination in adolescents, 446

on hormone therapy, 471-472, 489

on imaging services, 160-161

on immunizations, 233

on induced abortion, 717 on MedWatch, 158 on menstrual cycle, 567 on midwives, 193 on oral contraceptives, 359, 361 on patient safety, 63-64 on pelvic organ prolapse, 685 on professional behavior, 96 on quality health care in health care entitlement, 128-129

on quality improvement, 39

The American College of Obstetricians and Gynecologists (continued)

on sexual abuse among adolescents, 459 on sexuality education in adolescents, 452-454

on sexually transmitted infections screening, 403, 404b-405b

Women's Health Record of, 223, 224 The American Congress of Obstetricians and Gynecologists (ACOG), 186 operational mission statement of, 813 Safety Certification in Outpatient Practice Excellence program of, 59, 60b

Voluntary Review of Quality Care Program of, 54, 55b on women's medical home, 195

The Joint Commission

on ambulatory gynecologic surgery, 738, 741

on communication in patient safety,

72

on credentialing, 19

“Do Not Use” list of nonstandard abbre­viations of, 65, 66t

on ethical decision making, 130

on failure mode and effects analysis, 51 in governance of Department of Obstetrics and Gynecology, 4-5

National Patient Safety Goals of, 63, 70, 224, 487

on pain management, 601

on patient safety, 63

on quality improvement, 39

on root cause analysis, 52

Standards for Ongoing Professional Practice Evaluation, 30

“Universal Protocol for Preventing Wrong Site, Wrong Procedure, Wrong Person Surgery” of, 67, 738 The Obesity Society, obesity management guidelines of, 245-246, 249, 250 Third party

during physical examination, 100 protection of, on confidentiality, 99 Thromboembolic disease, 280-282, 472-473

Thyroid-stimulating hormone, in amenorrhea assessment, 570

Title VI of the Civil Rights Act, 805-806

Tobacco use, prevalence of, 329

Tracking systems, in patient communica­tion, 173-177

Tranexamic acid, in abnormal uterine bleeding management, 579 Transfer of patient, to another medical facility, for emergency medical conditions, 796-797

Transgender, definitions of, 505, 506b Transgender identity, spectrum of, 505, 506b

Transgender individuals, 505-510. See also specific types

American Public Health Association on, 505

barriers to health care for, 505, 507 caring for, 507-508 prevalence of, 505 types of, 505, 506b

welcoming patient care environment for, 508-509

Transition care, 163-164

Transport program, emergency medical treatment-related, government regulations for, 90-91

Transsexual, defined, 506b

Transvaginal mesh augmentation, in pelvic organ prolapse management, 685

Transvaginal native tissue repair, in pelvic organ prolapse management, 685

Transvaginal ultrasonography

in abnormal uterine bleeding evaluation, 578

in endometrial cancer evaluation, 652 Trazodone, for depression, 561 TRICARE program, of U.S. Department of Defense, 212

Trichomoniasis, 619

Trichotillomania, 534

Tricyclic antidepressants, for depression, 561

U

Ulcer(s), genital, diseases characterized by, 407t-408t

Ulipristal acetate, in emergency contracep­tion, 366

Ultrasonography

in breast cancer screening, 316-317 gynecologic, 161-162

Ultrasonography (continued) transvaginal

in abnormal uterine bleeding evaluation, 578

in endometrial cancer evaluation, 652 Ultrasound transducers, endocavitary, cleaning and preparing of, 153b

Undocumented immigrants, health care for, 209-210

Uninsured patients, health care for, 208-209 Unintended pregnancy

among adolescents, counseling related to, 456

conditions associated with increased risk of adverse health events resulting from, 383, 384b

prevalence of, 343, 344t-345t “Universal Protocol for Preventing Wrong Site, Wrong Procedure, Wrong Person Surgery,” of The Joint Commission, 67, 738

Urethritis, diseases characterized by, 408t-411t

Urinary incontinence, 689-695 causes of, 689, 691b costs related to, 689 differential diagnosis of, 689, 690b evaluation and diagnosis of, 689-692 management of, 692-693 prevalence of, 689 transient, causes of, 689, 691b

Urinary tract infections (UTIs), 697-701 evaluation and diagnosis of, 697-699 management of, 699-701, 700t recurrent, 697

management of, 701

in postmenopausal versus premeno­pausal women, 697, 698b

risk factors for, 697

U.S. Department of Agriculture (USDA) ChooseMyPlate web site, 247 Dietary Guidelines for Americans of, 251-256, 251b-254b

on dietary therapy for weight loss, 247 SuperTracker web site of, 248

U.S. Department of Health and Human Services (DHHS)

on child abuse, 545

on Clinical Laboratory Improvement Amendments, 787

U.S. Department of Health and Human Services (DHHS) (continued) on confidentiality, 98 on interconception care, 394 Office for Civil Rights of, 805-806 Office of Disease Prevention and Health

Promotion of, 207-208

Office of Minority Health of, 72 Quick Guide to Health Literacy, 207-208 2010 National Action Plan to Improve Health Literacy of, 208

U.S. Department of Labor, Occupational Safety and Health Administration within. See Occupational Safety and Health Administration

U.S. Food and Drug Administration (FDA) Amendments Act of 2007 of, 603 on calcitonin in osteoporosis prevention and treatment, 302

on Clinical Laboratory Improvement Amendments, 787

compounding law of, 158-159 on drugs for weight loss, 249 on dyspareunia in postmenopausal women, 633

on failure mode and effects analysis,

51

on female sexual interest/arousal disorder management, 680 on gonadotropin-releasing hormone antagonists in leiomyoma management, 595

on human immunodeficiency virus infection, 414

on latex sheets in sexually transmitted infections prevention, 415

on mammography facilities, 91 MedWatch program of, 157-158 on new medical devices, 110 on nonhormonal treatment during menopause, 476

on opioid abuse prevention, 338

on oral contraceptives, 359

on osteoporosis in breast cancer patients, 646

on pain management, 603

on prescription and over-the-counter drugs and devices, 157-158

Safety Information and Adverse Event Reporting Program of, 157-158

U.S. Food and Drug Administration (FDA) (continued)

on smoking cessation aids, 334

on tobacco industry regulations, 325 U.S. Medical Eligibility Criteria for Contra­ceptive Use, 2010, of Centers for Disease Control and Prevention, 273, 291-292, 346, 647

U.S. Preventive Services Task Force

on colorectal cancer screening, 324

on lung cancer screening, 325

on randomized clinical trials, 819, 820t U.S. Selected Practice Recommendations for Contraceptive Use, 2013, of Centers for Disease Control and Prevention, 347-349

USDA. See U.S. Department of Agriculture Uterine artery embolization

dilation and curettage with, in abnormal uterine bleeding management, 580

in leiomyoma management, 596 Uterine bleeding, abnormal, 573, 575-580

Uterine leiomyomas, 593-598 Uterine sarcomas, 651

UTIs. See Urinary tract infections

V

Vaccinations. See Immunization(s) Vaccine(s). See also Immunization(s) administration, storage, and handling of, 236

hepatitis B virus, 238-241, 239b-240b, 388, 400-401

Tdap, 388, 393 Vaccine Adverse Event Reporting System, 238

Vaccine information statements, 237-238 Vacuum curettage, 718

Vaginal atrophy

in breast cancer patients, 647

symptomatic, 632-633 Vaginal cancer, 649-651

American Society for Clinical Pathology on, 649

described, 649

management of, 650-651

Vaginal contraceptive ring, 361, 362b-363b Vaginal dryness, in breast cancer patients, 647

Vaginal lubricants and moisturizers, during menopause, 477

Vaginal mesh repair, in pelvic organ pro­lapse management, 685

Vaginal rejuvenation, 680

Vaginismus

described, 623, 624 evaluation and diagnosis of, 625 management of, 626

Vaginitis, 615-621. See also specific causes atrophic, 620 causes of, 615-620 defined, 615 desquamative inflammatory, 620 evaluation of, 615-616 symptoms of, 615

Vaginosis, bacterial. See Bacterial vaginosis Varenicline, in smoking cessation, 332-334, 333t

Vasectomy, 351

Vasovagal reaction, ambulatory gyneco­logic surgery and, 742-743

Vegan diet, 257-258

Vegetarian diet, 257-258 Veterans, women, health care for, 212-213 Veterans Health Administration, 212-213 VIN. See Vulvar intraepithelial neoplasia Violence. See also Abuse

adolescents and, 451-452 domestic, 537-543, 540b, 542b confidentiality related to, 543 counseling related to, in preconception care, 392 defined, 538

RADAR model of physician’s approach to, 540b

reporting of, laws regarding, 543 intimate partner, 537-543, 540b, 542b confidentiality related to, 543 consequences of, 538-539 counseling related to, in preconception care, 392 evaluation and management, 539­543, 540b, 542b

exit plan for leaving, 541, 542b nonacute presentations of, 539-543, 540b, 542b

patient safety after, 541

patterns of abuse in, 538 reporting of, laws regarding, 543

Violence, intimate partner (continued) screening for, 346-347, 540-541, 540b

suicide risk and, 542

Virtue-based ethics, 120

Vision loss, in older women, 483

Vitamin D

in adolescents, 447

in amenorrhea management, 571

in female-to-male transgender individuals, 508

intake of, 255 during menopause, 470

Voluntary Review of Quality of Care (VRQC) program, of the American Congress of Obstetricians and Gynecologists, 54, 55b

Von Willebrand disease, 577

VRQC program. See Voluntary Review of Quality of Care program

Vulvar atrophy, symptomatic, 632-633

Vulvar cancer, 656-657 evaluation and diagnosis of, 657 management of, 657 prevalence of, 656 prognosis of, 657

Vulvar disorders

in children, 425-427

infectious, 425-426 noninfectious, 426-427

Vulvar intraepithelial neoplasia (VIN), 633, 657

Vulvar pain, classification of, 623

Vulvar pruritus conditions associated with, 630b defined, 629 evaluation of, 629-631

Vulvar skin disorders, 629-634 diagnosis and management of, 631-633 evaluation of, 629-631 lichen planus, 632 lichen sclerosus, 631-632 vaginal atrophy, 632-633 vulvar intraepithelial neoplasia, 633 vulvar atrophy, 632-633

Vulvodynia, 623-626, 625/, 626b causes of, 623-624 classification of, 623 defined, 629 described, 623

Vulvodynia (continued) evaluation and diagnosis of, 624-625,

625/ management of, 625-626, 626b symptoms of, 629

Vulvovaginal candidiasis, 617-618, 618b classification of, 617, 618b complications of, 618 diagnosis of, 617 symptoms of, 617 treatment of, 617-618

Vulvovaginal disorders, symptoms of, 623 Vulvovaginitis

in children, 423-425

contact, 620 infectious, 424-425 irritant, 620

nonspecific, 423 types of, 423-425

W

Waist circumference, measurement of, 246 Wart(s), genital, in children, 425-426 Weight. See also Fitness

assessment of, 245-246

as fitness component, 245-250

in preconception care, counseling related to, 388-389

Weight gain depot medroxyprogesterone acetate and, 357-358

smoking cessation and, 332

Weight loss benefits of, 246-247 dietary therapy for, 247-249, 248t maintenance of, 250 polycystic ovary syndrome and, 669 pharmacotherapy for, 249 surgery for, 250

Well-woman care, 201-563

Whiff test, 615

WHNPs. See Women's health nurse practitioners

WHO. See World Health Organization Whole medical systems, 265-266 Withdrawal, in family planning, 365 Women 65 years and older, 479-491 abuse of, 487, 543-545 alcohol abuse among, 486-487 bladder and bowel function in, 483

Women 65 years and older (continued) cancer in, 485

cervical cancer in, 649 cognitive function in, 481-483 communication issues in, 479-480 comprehension in, 480 contraceptive use in, 350 cardiovascular disease in, 484 fractures in, 484-485 functional assessment of, 480-483 hearing difficulties in, 483 immunizations in, 485-486 infections in, 485-486 medical conditions in, 484-486 medication use among, 487-489 mental status in, 481-482 nutritional deficiencies in, 486 osteoporosis in, 484-485 prevalence of, 479 psychosocial concerns in, 486-487 sexual dysfunction in, 486-487 vision loss in, 483

Women with disabilities, 511-516 abuse of, 515 appointment scheduling for, 512b-513b autonomic dysreflexia in, 514-515 barriers to health care for, 511 contraceptive use by, 515 developmental

consent issues, 514 examination and treatment of, 514 function levels of, 514

Women with disabilities (continued)

health concerns of, 514

health education for, 513b menstrual suppression in, 515 office practices for, 512b-513b screening of, 514

Women's Health Initiative trial, on hor­mone therapy and cardiovascular disease, 473

Women's health nurse practitioners (WHNPs), certification and training of, 190

Women's Health Record, of the American College of Obstetricians and Gynecologists, 223, 224

Women's medical home, 195

World Health Organization (WHO)

on depression, 555, 556b

fracture risk assessment tool of, 299-301, 300t

on genital cutting, 493

Patient Safety program of, 738

on probiotics, 266

“Safe Surgery Saves Lives” of, 738

Surgical Safety Checklist of, 67, 68f, 70, 738

Y

Youth Risk Behavior Survey (2011), on adolescent driving, 451