It is just over 50 years since Prof Ian Donald, a Scottish obstetrician, pioneered the use of ultrasound in medicine. His article published in the Lancet in 1958, ‘Investigation of abdominal masses by pulsed ultrasound’, was a milestone in the field of imaging. Undeniably, the development in ultrasonography that has had the widest reach is imaging unborn child. Ultrasound is also key to assessment of acute gynaecological presentations and is a pivotal investigation in refining a differential diagnosis. The O&G Magazine Advisory Committee, which sets the themes for each issue, believes the advances in imaging are deserving of a whole issue.
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This issue of O&G Magazine is devoted to controversy. Those who have been in practice for more than a couple of decades will recognise just how much our practice and ideas have changed within our professional lifetimes. In this issue of O&G Magazine we publish the views of a number of erudite experts, guiding us through areas of controversy, and we have ventured to ask an economist to contribute – a first for us.
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Office gynaecology is a mainstay of practice for many of the readers of O&G Magazine and may well become more important in the future. While the topics covered by the articles in this issue may seem familiar, in each case there are advances in techniques, therapy and accepted practice that can add to the armoury of clinicians.
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In this issue, we have tried to cover most therapeutic groups relevant to this specialty. In addition to this, we are quite chuffed with our first O&G Pocket Guide: a mini guide on the other drug groups our patients take, but we don’t usually prescribe ourselves. We hope it serves as a reference for our consult rooms, allowing us to stay more in touch with our patients.
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Pelvic floor considerations run the full gamut of obstetric and gynaecological care. Whether it is attending a normal vaginal delivery or performing a clinical examination of a woman with prolapse, ultrasound assessment of pelvic floor musculature or learning novel surgical techniques, pelvic floor care spans the everyday to the cutting edge.
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The unexpected death of a baby during the latter part of pregnancy is a devastating event for a couple. Pregnancy is usually a time of joy and expectation, and such a loss can have prolonged emotional consequences. The O&G Magazine editorial team look forward to hearing from our readership as you read these articles over the festive season. We wish all of you the best for a happy Christmas and a year full of hope.
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Nurture is defined as ‘to care for and encourage growth or development’. This issue of O&G Magazine explores aspects of nurturing our workforce of obstetricians and gynaecologists. This is essential for the healthy future of the profession and the health of women in Australia and New Zealand.
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In this issue of O&G Magazine we focus on the challenges faced by women who live in the Asia-Pacific region, and the challenges encountered by those trying to help. You will find articles offering an overview of the problems, information about organisations working towards change and some stories from the frontlines from people trying their best to change the lives of women and families in our region.
The sad fact remains: women continue to die in childbirth and the puerperium. Birth, pregnancy and the postpartum period are still dangerous. These facts cannot be pushed to the back of our consciousness and, moreover, as responsible clinicians, we must confront them in order to stop women dying from preventable or treatable conditions. It is our hope that everyone can learn something from this issue and that we can work towards lowering the maternal mortality rate further.
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Sex: all consuming or incidental, pleasurable or painful, joyous or traumatic, procreative or recreational, consensual or criminal – nothing else plays such a protean role in our lives. In this issue of O&G Magazine we have articles covering a wide range of sexual issues.
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‘We are what we eat’ and, in many circumstances, rather what we don’t eat, so hopefully with the help of this issue of O&G Magazine we will be able to make some sense of the potential for deficiencies particularly in our pregnant patients.
Welcome to the Winter issue of O&G Magazine, which takes evidence-based medicine (EBM) as its theme. This term first appeared in the early 1980s, and the concept has spread into the collective consciousness of all medical practitioners, including obstetricians and gynaecologists, so that it is now a truth universally acknowledged that our clinical practice, in principle at least, should always be based on ‘the evidence’.
Unless our work is closely allied to oncology, it can be difficult to keep pace with changes in cancer management. In this issue of O&G Magazine, we have asked a group of experienced specialists to share their insights.
This edition of O&G Magazine is themed 'Pain' and represents a substantial, but digestible, summary of a topic that is an integral part of the working life of every Fellow, Diplomate and Trainee in O and G. It would be a fair assessment that, to date, structured teaching in the management of pain has been less than that required to fully equip our graduates to manage these sometimes very complicated and invariably multifactorial clinical situations.
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The late and great Scottish obstetrician Sir Ian Donald's lament is probably not far off the mark even today. 'Come back and see me when the baby is six weeks old', is our usual predischarge request to postnatal mothers. A rather flippant approach compared pathway to lactation or a return to fertility. The pregnant state, which has developed over nine months, no longer exists and this new puerperal state affects every part of a woman's body. For example, the uterus weighs 1kg after birth, but less than 100g by six weeks.
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This Spring edition of O&G Magazine follows the theme of Indigenous health, with an appropriate focus on the health of Indigenous women and their families. It is timely for a range of reasons pertinent to the medical profession and the wider community generally, and organisations such as the specialist colleges collectively and individually.
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In view of the enormous amount of attention paid to homebirth in the lay and medical press, it is timely to publish an issue devoted to homebirth. In preparing it, we approached a large number of people to write for us, in order to solicit a wide range of viewpoints.
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