Abstract
We hope you were all pleased with your first issue of Obstetric Medicine: the Medicine of Pregnancy, and that you share with us a feeling that the launch of the journal represents an important milestone in the development of our small specialty. It was fitting that the journal was launched at the 4th Scientific meeting of the International Society of Obstetric Medicine in Washington DC. It is our aim to apply for the journal to be on Medline by the time of the next Scientific meeting, which will take place in Melbourne, Australia in October 2010. The HighWire website for Obstetric Medicine is also now live… take a look at
In Washington we were treated to a superb overview of new developments in thyroid disease in pregnancy by Alex Stagnaro-Green, and in this issue of the journal you will find an equally important endocrine topic, type 2 diabetes in pregnancy. Type 2 diabetes is becoming increasingly common in pregnancy and it is now accepted that these women have risks in pregnancy that equate to those of women with type 1 diabetes. Erin Keely discusses these risks and the importance of counselling such women, and optimising their care and diabetic control prior to pregnancy. Obesity is the epidemic behind the increase in diabetes and in the retrospective study by Dr Chereshneva and colleagues, obesity significantly increased the risk of several adverse pregnancy outcomes including gestational diabetes, hypertension, preterm rupture of membranes, preterm delivery and caesarean section. Over 40% of their ethnically diverse population from inner London, for whom BMI data were available, were overweight or obese.
The aim of the journal is to bring you the scientific as well as the clinical research informing the medicine of pregnancy. This sometimes leads to an eclectic mix of articles. Keelin O'Donohue reviews the fascinating role of fetal microchimerism in maternal health during and after pregnancy. Fetal microchimerism is defined as ‘low levels of fetal cells harbouring in maternal blood and tissues during and for years after pregnancy’. But as O'Donohue explains, ‘it is still not clear whether microchimeric fetal cells persisting in the mother are an incidental finding, are naturally pathogenic or act as reparative stem cells’. Microchimeric fetal cells have been demonstrated in tissues from women with systemic sclerosis, primary biliary cirrhosis, systemic lupus erthymatosus and autoimmune thyroid disease. However, fetal microchimerism may have a beneficial influence on survival in various cancers and may also explain the protective effect of pregnancy against disease in later life.
Also in this issue, Mandish Dhanjal provides practical advice on the range and choice of contraceptive methods available for women with different medical problems. Although somewhat counterintuitive, no prepregnancy counselling consultation is complete without some consideration of contraceptive methods. This is relevant for all women whether wishing to delay or avoid pregnancy. Anyone attending the moving and thought-provoking session on maternal mortality in the developing world at ISOM in Washington can be left with no doubt of the importance of contraception to female reproductive health.
The Editors-in-Chief, from left to right, Sandra Lowe, Catherine Nelson-Piercy and Karen Rosene-Montella