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