Abstract
News of unusual or interesting cases spread throughout the hospital or clinic like a virus. Everyone wants to hear about the patient with the rare syndrome or unheard of side-effect. Such cases engender fear, excitement and trepidation in the treating team and the patient. Often such a case will generate the suggestion from a consultant to junior doctor: ‘You should write this up’. And yet the humble case report is considered a lowly ranked publication. Single case reports are rarely cited and do not contribute to the Impact Factor for the publishing journal. They are given the lowest level of evidence rating and many journals have abandoned publishing case reports.
Historically, many new diseases have been recognized only when a number of case reports or small series are published. Case reports provide the only pathway to report rare conditions, unusual adverse events, unexpected complications or novel clinical scenarios. Those practising in the field of obstetric medicine are often presented with a woman suffering from a pre-existing or new condition whose behaviour is altered by the pregnant or postpartum state. For an individual clinician this may be the first time they have confronted this particular condition in pregnancy. The obstetrician is anxious, the patient and her family are bewildered and the ‘textbook’ offers the standard descriptions with no mention of pregnancy. In managing such cases, we tend to turn to colleagues, textbooks and journals for some guidance. Frequently, the only reported experience will be a limited number of case studies that at least provide some insight into the condition.
In assessing case reports for publication, our reviewers consider a number of criteria. Does the case report thoroughly and concisely describe the condition, its management and outcome? Are all alternative diagnoses considered and discussed? How does the case add to the existing literature? Does the case illuminate an aspect of unique obstetric biology? How does pregnancy or the postpartum state alter this particular condition or its management? How will this case alter the management of future patients with this condition? What hypotheses does the case report generate? What future research should be performed to assist in managing similar cases in the future?
Obstetric Medicine: The Medicine of Pregnancy recognizes the value of the Case Report and commits to regularly publishing these submissions. We invite you to share your experiences with your colleagues in this field. In this edition, we have reports on a common condition in an unusual setting (typhoid fever), a rare but important differential diagnosis of dizziness in pregnancy (cerebellar haemangioblastoma) and the management of pregnancy in a woman with pre-existing chronic lymphocytic leukaemia. We would also like to draw your attention to the Journal Watch, which describes the published literature on H1N1 influenza in pregnancy.
We look forward to sharing your case experiences with our international readership.