Reflections and expectationsредакционная статья
Аннотация: With this last 2013 issue of AOGS it is time for reflections. This issue contains an informative and interesting article by Per Olof Janson, former president of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG) and Chief Editor of the Federation's journal, Acta Obstetricia et Gynecologica Scandinavica (AOGS). This contribution is a reflection and a summary of the 90-year history of NFOG and AOGS (pp. 1344-1352) and the recommendation to add this to your Christmas reading is hereby given. The year 2013 has been a turning point in many ways for AOGS. The journal went from a primarily paper publication posted to all NFOG members to an on-line journal where the main reading access is through the web, although print still exists. The number of members signing up for this new on-line access has increased dramatically in the last few months. It is worth noticing that the AOGS Apple iPad® app is now available for all NFOG members and if you have not yet downloaded it you have a great Christmas present waiting for you. In 2013 AOGS published almost 200 research articles of which almost half were authored by our Nordic colleagues. AOGS has again increased its impact factor although not yet crossed the magic line of surpassing an impact factor of 2.0, but strategies has been prepared as to reach this. We also had one major theme issue of the abnormally invasive placenta and a supplement with abstracts from a meeting on fetal programming. The NFOG members are active and 2013 was a year with several interesting scientific meetings held in the Nordic countries. The 4th Nordic Congress on Endometrisos was held in Turku, Finland, the European Congress of the International Society for the Study of Hypertension in Pregnancy in Tromsø, Norway, and the first global conference on contraception, reproductive and sexual health in Copenhagen, Denmark. Next year will i.a. see a meeting on preterm labor in Odense, Denmark, and of course the Nordic Congress of Obstetrics and Gynecology in Stockholm, Sweden, – always a major event, introduced in this issue by Magnus Westgren and colleagues (p.1343). A Nordic movement has become increasingly visible during 2013, namely to reduce obstetric anal sphincter injuries. The Finnish concept of “hands-on” to protect perineum during delivery has been shown to reduce the frequency of sphincter injuries in Norway 1 to levels known to exist in Finland, and this has also been adopted more widely in the Nordic countries. The concept is not new, being related to the older Ritgen′s maneuver 2, but needs now to be re-awakened to make vaginal delivery safer for the mother and thus also to work against the rising demand for cesarean section rather than normal delivery. The first research article (Ragnhild Skråstad and colleagues, Ålesund and Trondheim, Norway, pp. 1353-1360) describes a randomized trial on ultrasound screening in the third trimester which has remained unpublished for two decades, for complex reasons. We owe it to the patients and to women in general to publish good studies and not least those which were conducted by randomization. To have such vital data unavailable to the professions and the public is not in the best interests of anyone. But the authors can be praised for not letting the study rest. The current demand for registering randomized studies in international registers was instituted in part to ascertain that such trials were ultimately reported and international guidelines on how they should be conducted and reported also exist (Equator-network.org). The study did not show a clear benefit from third trimester fetometry screening, which yet is widely used. Simple clinical examination with attention to risk cases and applying ultrasound there along with Doppler investigations of the fetus, may yield the same overall results. But as the authors state this needs better investigation and the Nordic countries could provide the basis for such well-designed large-scale efforts. Celine Lönnerfors and colleagues in Malmö, Sweden (pp. 1361-1368), report on port-site metastases in connection with robotic surgery. With the increasing use of these techniques such observations acquire importance in order to avoid serious complications. Advanced disease is as expected a major factor, but histology also matters and the contributing mechanisms are discussed by the authors. Anti-Müllerian hormone level evaluation is rapidly becoming an established part of infertility evaluation 3, not least as a marker of ovarian follicle reserve, but Sezai Sahmay and colleagues fom Istanbul, Turkey, report on this in relation to polycystic ovary syndrome on pp. 1369-1374, showing that in this condition there is likely place for using these measurement in women with uncertain other diagnostic criteria. From Aberdeen in Scotland, UK, comes a report on a subject which is likely to raise some controversy (Mairead Black and co-workers, pp. 1383–1387). Should midwives be trained to do instrumental deliveries, such as applying the ventouse or even forceps? There are parts of the world where they must be able to do this, but does it also apply to middle-resource and high-resource countries where trained doctors are available to do this? The difficulty in doing an instrumental delivery, particularly with the ventouse, is not the procedure itself, but the decision of when this should be done and under what circumstances. The position of the fetal head in the pelvis, moulding, pelvic size and some major principles for using these devices must be taught in simulated situations and ultimately live circumstances. If that is done and critical care and judgment exercised, it may matter less who does the procedure, and a key to success may also be good co-operation between midwives and obstetricians. The article by Kim Stene-Larsen and colleagues from Olso, Norway and Copenhagen, Denmark (pp. 1388-1389) requires your careful reading, because the authors show firstly how little official words of warning on alcohol use in pregnancy may matter, how common the use of alcohol to a minor and even major degree is, and who the women are who are not able to abstain as recommended. We shall follow this up with a Guest editorial in our January issue. The article by Kai Part and in a European consortium on teenage pregnancies in Europe and sexual and reproductive health services for young people in Europe shows some advances overall, but in many countries the situation is less than ideal, even though it is much better than the frightful data released from the World Health Organization indicate (www.who.int/maternal_child_adolescent/topics/maternal/adolescent_pregnancy/en/). There are countries where almost half of teenage women reach adulthood having become mothers. An estimated 70 000 young women never reach proper adulthood because they die as a result of enforced marriage at a very young age, with premature pregnancies coupled to a lack of essential maternity and general health services. There are ways to improve this 4, also in Europe. Take a little time to study the graphs and tables in this article on pp 1395-1406 and ask yourselves what we can do better in our own countries and how we as gynecologists should contribute. We can end the year by saying that academic discourse in the journal has really taken off. Almost 40 letters to the editor were published in 2013, showing an interest in the journal′s contents which also underscores another remarkable change for AOGS during 2013. Pregnancy is not associated with recovery from eating disorders (pp. 1398–1404)
Год издания: 2013
Издательство: Informa
Источник: Acta Obstetricia Et Gynecologica Scandinavica
Ключевые слова: Reproductive Health and Technologies
Другие ссылки: Acta Obstetricia Et Gynecologica Scandinavica (PDF)
Acta Obstetricia Et Gynecologica Scandinavica (HTML)
PubMed (HTML)
Acta Obstetricia Et Gynecologica Scandinavica (HTML)
PubMed (HTML)
Открытый доступ: bronze
Том: 92
Выпуск: 12
Страницы: 1341–1342