Reflections and expectations

摘要

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 Lö