Introducing Expert Review of Obstetrics & Gynecology

As obstetricians/gynecologists, we are in the best position to comment on the issues surrounding birth. For many of us, and our patients, birth is usually associated with great joy and trepidation. The joy of bringing new life into this world is frequently a reason why many of us decide to enter this field. On the other hand, this is usually tempered with some trepidation: how will this child be cared for, what struggles and barriers lie ahead and how will the child respond to them?

In a similar manner, the birth of a new journal brings joy and trepidation to those who have ‘labored’ to bring it to ‘life’. Obviously, the accomplishment of starting a new journal brings great pleasure to those who help ‘conceive’ and make possible the idea, growth and development. However, this is usually tempered by apprehension: will people read it, consider it an authoritative and valued source of information and use it to help their academic and clinical practice? As with children, only time will tell but, genetics and environment will be important in determining success or failure.

To this end, we proudly put forth the launch issue of Expert Review of Obstetrics & Gynecology. Our specialty has witnessed considerable changes over the past decade, with the increasing inclusion of genetic information into the care of the obstetric and gynecological patient, the move to minimally invasive procedures by gynecologists, urogynecologists and oncologists and the increasing recognition of the importance of counseling our patients concerning sex and sexuality, diet, exercise, stress reduction and interpersonal relationships, among other important lifestyle issues. These changes have occurred within the context of continuing progress in all fields of women’s health, including contraception, menopause management, sexually transmitted infection, infertility evaluation and therapies, maternal–fetal medicine and the prevention, diagnosis and treatment of gynecological malignancies.

Indeed, for those of us who work in the clinical, academic and research aspects of women’s health, the ability to access a comprehensive and well written source of reliable information is becoming a more essential part of maintaining and improving one’s practice. With all of the changes that have occurred since many of us completed our formal training, the inability to remain current with critical bench science and clinical advances will needlessly doom clinicians and their patients to a lower standard of care. However, remaining current in the width and breadth of obstetrics and gynecology can be a daunting task. Dozens of journals, thousands of articles, all serve to challenge the professional to choose from a veritable smorgasbord of evidence, a task most are unwilling, or unable, to undertake. So, a journal such as Expert Review of Obstetrics & Gynecology can serve to bring ground-breaking and important laboratory and clinical advances to its readers, without the need to spend considerable time and resources going through numerous journals and periodicals.

Good examples of the need for readily available and accurate information on advances in obstetrics and gynecology can be found in three disparate fields of interest: contraception, menopause management and prenatal screening. The development of new contraceptive options is not a new phenomenon; such developments have been a hallmark of reproductive healthcare for the past five decades. However, the dissemination of medical information by the lay press has created havoc and concern among many clinicians and women who are using hormonal contraceptives. Most recently, nonscientific reports have associated, without clinical evidence, the use of the transdermal patch (combination of ethinylestradiol [EE] and norelgestromin; Ortho-Evra™) with an increased risk of cardiovascular events. This potential clinical association is ostensibly strengthened by pharmacokinetic studies that demonstrate that women who use the patch have an increased serum estradiol level compared with women using a 35-µg ethinyl estradiol pill. However, pharmacokinetic studies are effective in explaining clinical phenomena, not predicting them. To this end, a recent study by Jick and colleagues showed no difference in thromboembolic events between users of the patch and users of a 35-µg EE pill with norgestimate [1].

Opinions concerning menopausal management continue to be guided by the outcomes of the Women’s Health Initiative (WHI). However, a veritable torrent of articles and papers have made interpretation of the WHI more complicated than originally reported, especially as the WHI did not expressly study symptomatic women who are most likely to consider the use of hormone therapy. Recent articles have reported on additional potential benefits and risks of hormone therapy, particularly as they relate to specific characteristics of menopausal women. Accordingly, such information needs to be disseminated so that evidence-based therapeutic decisions can be made and discussed with women who are considering a variety of therapeutic options.

Prenatal screening is undergoing considerable and rapid changes. Since the incorporation into obstetrical practice of screening protocols for Mendelian disorders, such as cystic fibrosis and ethnic-specific conditions ranging from familial dysautonomia to β-thalassemia, the outcomes of the Human Genome Project are changing our approach to the diagnosis, prevention and, eventually, the treatment of genetic disease. Similarly, the screening of pregnancies for fetal chromosome abnormalities is one of the most rapidly changing fields of study and practice in obstetrics. Maternal screening for fetal chromosomes was initially carried out via serum analyte screening in the second trimester. The past decade has witnessed the incorporation of first-trimester ultrasound and maternal serum analyte measurements in an increasingly complicated array of sequential, integrated and unified algorithms that are confusing at best. Having a reliable source for evidence-based reviews of this field of interest would thus be an especially important tool for obstetric providers.

Genetics and environment help determine how children will develop and also determine whether journals will succeed. Genetics refer to the quality and work ethic of the editorial board. Environment refers to the publisher and the work needed to produce a high-quality publication that is well recognized by those who work in the field. In this regard, Expert Review of Obstetrics & Gynecology can boast of excellent genes and a supportive environment that should not only produce a high-quality periodical but also increase the likelihood of success and a wide readership.

Genes and environment notwithstanding, the most important key to success of any journal is you, the reader. We believe that Expert Review of Obstetrics & Gynecology will provide you with the high quality and well written review periodical that will increase your fund of knowledge and improve the care that you provide to your patients. So, as we launch our inaugural issue, we thank you for your readership and support and look forward to providing you with a first-rate review of women’s healthcare for a long time to come.