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ObGyn Update FY14

ObGyn Update FY14. ObGyn Dept NH XXX. Topics. Abortion Policy Update Pap Smear Update to MANMED 1 st Trimester Bleeding Flowchart Unplanned Pregnancy Prevention Efforts OPNAVINST 6000.1C to 1D Same Sex Partner Benefits Sexual Assault and SAFE Update. Abortion Policy Update.

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ObGyn Update FY14

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  1. ObGyn Update FY14 ObGyn Dept NH XXX

  2. Topics • Abortion Policy Update • Pap Smear Update to MANMED • 1st Trimester Bleeding Flowchart • Unplanned Pregnancy Prevention Efforts • OPNAVINST 6000.1C to 1D • Same Sex Partner Benefits • Sexual Assault and SAFE Update

  3. Abortion Policy Update Current guidance from NDAA FY13 and ASD/HA memo 17 Mar 2013 New policy in review, not yet released Pregnancies resulting from sexual assault/rape or incest may be terminated using federal resources at MTF’s or civilian facilities Same benefit if life of mother threatened by carrying pregnancy to term

  4. Abortion Policy Update Patient’s attestation and physician’s good faith evaluation is sufficient assessment to proceed with treatment. Conscience exemption from participation still in place If physician’s good faith exam is not consistent with pregnancy resulting from rape/incest, obtain prompt 2nd opinion

  5. Abortion Policy Update State/Country laws will guide MTF practice for counseling, use of U/S, etc. Patient eligible for transfer to another MTF/civilian site if gestational age restrictions preclude care in given state SARC should be notified in all cases Sexual assault reporting restrictions still apply

  6. Pap Smears and MANMED 21 yo – 1st Pap, regardless prior history 21-29 – Pap only, q 3 yrs 30-65 – Pap and HPV co-test, q 5 yrs > 65 – cease testing Assumes no other risk factors

  7. Pap Smear Schedule Alterations H/O HGSIL, CIN 2,3 H/O DES H/O total hyst and no h/o dysplasia Etc Flowcharts at www.asccp.org

  8. 1st Trimester Bleeding Flowchart – see Handout

  9. Unplanned Pregnancy Prevention BUMED Advisory Board Assessing HCP training, experience Assessing personnel exposure during accessioning, schools, GMT, etc. Next steps: Improvements based on findings above Assess receptiveness of patients to input

  10. OPNAVINST 6000.1C Update Due for release in 2-3 months (?) Updates: Egg Donation prohibition Immunizations Infertility Pt management Pregnancy loss F/U and disposition Next PFA cycle after pregnancy Collateral duty of PAPA

  11. Same Sex Partner Benefits Awareness of ACOG recommendations for lesbian demographic Special Population publication Committee Opinion #525 Fertility assistance – refer to ObGyn No new policies at this time

  12. Sexual Assault Victims and SAFE Review DODINST 6495.02 ALWAYS include SARC/SAVI/etc. Know how to access SAFE – BUMEDINST 6310.11A Understand reporting requirements High visibility issue – ensure excellent medical care and accurate administrative process

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