A C TA Obstetricia et Gynecologica



DOI: 10.1111/aogs.12551

The front cover of this first 2015 issue shows the flags of all the Nordic countries and their autonomous regions, an area with about 28 million inhabitants, – linked politically through the Nordic Council, and more importantly by history, cultural and ethical values. In obstetrics, gynecology and reproductive medicine the Nordic Federation of Societies for Obstetrics and Gynecology, NFOG, provides many inter-country links for our profession: through a board which represents the five national societies at a supra- and international forum, through the NFOG working committees, the NFOG Fund, the 2yearly Nordic congresses (the next one in Helsinki in 2016), the NFOG webpage and primarily through AOGS, which now is entering it0 s 94th publication year. With the journal now largely being accessed on the web, front cover changes will be reduced, but the year will see a renewal of many aspects relating to this ever-young old journal, both in lay-out and content handling, – a positive evolution that will build on the existing quite strong position of the journal. We hope to increase quality of the journal and raise the impact factor still further from 2.005 towards three point zero. Throughout a ninety-four year history, Acta or AOGS has seen many new beginnings and this, with a new chief editor and editorial structure changes, is one more good sign of being very much alive and up-to-date. The new year starts by a Guest Editorial by Maria Milland in Copenhagen, Denmark and H akon Bolkan in Trondheim, Norway (pp. 5–7), on the still serious situation in Western Africa where it now seems the ebola epidemic is being controlled in a better way than only a couple of months ago (1). But huge problems still exist, not least in manning the health sector. The authors discuss practical ways of meeting this basic need. Perhaps these considerations have wider implications, as in highresource countries there is also task shifting in recent years with better education of, for example, the nursing profession. Nurses and technically educated staff not only support doctors in the daily work, but do handle complex situations independently, as dictated by their education and skills training. This may be vital for saving resources in high resource settings, while in low resource countries

it can be vital for survival itself, not least when it comes to maternal health. The commentary from Zachary Nash and colleagues from London, UK (pp. 8–12), and the brief comment by Per Børdahl of Bergen, Norway, on pp. 13–14, are bound to create controversy and discussion. Should rotational forceps be reintroduced and what about the concerns that forceps and forced instrumental delivery will increase the risk for later female health problems like genital prolapse and incontinence? Do follow the discussion on this in the months to come. The review from Denmark (Stina Lou and colleagues, Aarhus, pp. 15–27) which shows that screening for Down0 s syndrome does in general not cause anxiety for women/parents is important information from a country where such screening is well established. This is followed by a study from Tromsø in Norway (Marit Falkeg ard and co-workers, pp. 28–34) where it is shown that information from the patient herself on hypertensive complications is reliable. Women remember what complicates their pregnancies. This is valuable for epidemiological studies, but even more so for everyday clinical reality. Then the randomized study by Esther Westen and colleagues from Tanzania, the Netherlands and the UK on rational use of antibiotics at cesarean section will hopefully serve to reduce overuse of antibacterial drugs which as the authors say, is widespread in low resource countries (pp. 43–49). The national surveillance study on birth-related hemorrhage from Campinas, Brazil (Edilberto Rocha Filho and colleagues, pp. 50–58) must also be mentioned. A rapidly growing problem in so many middle income countries is the excessive use of cesarean section on poorly based indications, while higher maternal age and obesity combine to add to the risk. Observe Table 1 on p. 52 showing the WHO list of life-threatening maternal conditions (2). Their Discussion has some good points, emphasized also in many articles in AOGS in the last couple of years. On the gynecology side we feature a study by Satu Tarjanne and colleagues in Helsinki, Finland (pp. 72–79) on the serious problem of colorectal deeply infiltrating endometriosis. Again the need to centralize such treat-

ª 2014 Nordic Federation of Societies of Obstetrics and Gynecology, Acta Obstetricia et Gynecologica Scandinavica 94 (2015) 3–4


Editors Message

ment to a few centers in the Nordic countries and elsewhere stands out, if optimal results are to be obtained. The study by Karin Glavind and colleagues in Aalborg, Denmark (pp. 80–85) is a clinically useful one, showing that most women who need conventional prolapse repair have no sexual function problems afterwards, – it is rather the converse. There is also a study from the Danish cancer registry and allied institutions in Copenhagen, Denmark (Cecilie Madsen and co-workers, pp. 86–94) which should be noted as it provides in a very large material confirmatory evidence of the protective effects against at least certain ovarian tumors that follow tubal ligation or tubal removal. Noxious stimuli ascending from the uterine cavity hitting the ovarian surface seem to be avoided. Time to rethink current trends for male sterilization? Lastly the study Tine Thorup and Helle Zingenberg from the Copenhagen area of Denmark on pp. 102–105 highlights a world-wide problem where a medical investigation, prenatal ultrasound, is being marketed not for medical benefit, but purely for profit in an unregulated way, sometimes by professionals, but also not so professional individuals with questionable “training”. As doctors we should speak strongly out against such misuse of powerful medical technology and exploitation of the


public. We must do this at a society level and in a way whereby our voices are clearly heard: against rip-offs and waste; for rational use of medical technology. May I end on a note on seven and a half year as your chief editor? It has been a pleasure to serve the readers and authors in this time and see the journal gain in popularity and strength, both in the Nordic countries an internationally. There will have been frustrated authors, not least when revisions were asked for. With quality as a goal this has though lead to better articles and contented authors, glad to have their work highlighted. As AOGS enters a new phase towards completing 100 years of publication it requires our combined support and our strive to raise quality, visibility and impact even more. References 1. Geirsson RT. Ebola and adverse circumstances. Acta Obstet Gynecol Scand. 2014;93:957–8. 2. Say L, Souza JP, Pattinson RC. WHO working group on Maternal Mortality and Morbidity classifications. Maternal near miss – towards a standard tool for monitoring quality of maternal health care. Best Pract Res Clin Obstet Gynaecol. 2009;23:287–96.

ª 2014 Nordic Federation of Societies of Obstetrics and Gynecology, Acta Obstetricia et Gynecologica Scandinavica 94 (2015) 3–4

A new beginning.

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