Obstetrics, Gynaecology and Reproductive Medicine RSS feed: Current Issue. Obstetrics, Gynaecology and Reproductive Medicine is the continuously updated review for obstetricians, gynaecologists and reproductive medicine specialists (formerly Current Obstetrics & Gynaecology). Obstetrics, Gynaecology and Reproductive Medicine is an authoritative and comprehensive resource that provides all obstetricians, gynaecologists and specialists in reproductive medicine with up-to-date reviews on all aspects of obstetrics and gynaecology. Over a 3-year cycle of 36 issues, the emphasis of the journal is on the clear and concise presentation of information of direct clinical relevance to specialists in the field and candidates studying for MRCOG Part II. Each issue contains review articles on obstetric and gynaecological topics. The journal is invaluable for obstetricians, gynaecologists and reproductive medicine specialists, in their role as trainers of MRCOG candidates and in keeping up to date across the broad span of the subject area. Over any three year period, a subscription will ensure access to up-to-date information on the full range of obstetrics, gynaecology and reproductive medicine topics. The layout of the journal, including the design and colour, enables fast assimilation of key information. For ease of reference, Obstetrics, Gynaecology and Reproductive Medicine is available in print and online formats. Formerly Current Obstetrics & Gynaecology http://www.obstetrics-gynaecology-journal.com/?rss=yesElsevier Inc.en © 2012 Published by Elsevier Inc. All rights reserved. Obstetrics, Gynaecology and Reproductive Medicine1751-7214226June 2012 © 2012 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.obstetrics-gynaecology-journal.com/article/PIIS1751721412000802/abstract?rss=yesEditorial Board10.1016/S1751-7214(12)00080-2Obstetrics, Gynaecology and Reproductive Medicine 22, 6 (2012)2012-06-01Obstetrics, Gynaecology and Reproductive Medicine2012-06-01226S1751-7214(12)X0006-Xiihttp://www.obstetrics-gynaecology-journal.com/article/PIIS1751721412000401/abstract?rss=yesAbstract: Hypertension is a common complication of pregnancy and remains a major cause of maternal and perinatal morbidity and mortality worldwide. Hypertensive disorders range from mild gestational hypertension to severe pre-eclampsia which remains one of the leading causes of maternal death in the UK. Although there have been major advances in understanding the pathophysiology of the disease in recent years, interventions to prevent hypertensive disorders in pregnancy have had disappointing results. Due to their unpredictable nature and potential poor outcomes, patients with hypertensive disorders of pregnancy warrant cautious care with consultant obstetric, neonatal and anaesthetic involvement to optimize both maternal and fetal outcomes.Hypertension in pregnancyFergus P. McCarthy, Louise C. Kenny10.1016/j.ogrm.2012.02.009Obstetrics, Gynaecology and Reproductive Medicine 22, 6 (2012)2012-06-01Obstetrics, Gynaecology and Reproductive Medicine2012-06-01226S1751-7214(12)X0006-XReviews141147http://www.obstetrics-gynaecology-journal.com/article/PIIS1751721412000413/abstract?rss=yesAbstract: Dyspareunia is a form of sexual dysfunction that can significantly affect quality of life and cause relationship difficulties. It is a symptom of a variety of disease states with components of both physical and organic dysfunction. Obtaining a comprehensive sexual history in an outpatient setting requires a high level of professionalism. A systematic examination of the lower genital tract is necessary to rule out any obvious cause, though further investigations such as ultrasound infrequently provides additional information. Diagnostic laparoscopy is an invasive procedure that is of limited use in the first line investigation of dyspareunia but may help detect pelvic adhesions or endometriosis in those where this condition is suspected. Before embarking on a laparoscopy it is important for the patient to be aware of a management plan in the event that the laparoscopy is negative. There are data to suggest that empirical medical treatment after a clinical diagnosis of endometriosis is effective and has the advantage of avoiding any invasive procedures. Psychosexual causes are important to consider during the assessment of the patient experiencing dyspareunia.Dyspareunia in gynaecological practiceVladimir Revicky, Sambit Mukhopadhyay, Edward Morris10.1016/j.ogrm.2012.02.010Obstetrics, Gynaecology and Reproductive Medicine 22, 6 (2012)2012-06-01Obstetrics, Gynaecology and Reproductive Medicine2012-06-01226S1751-7214(12)X0006-XReviews148154http://www.obstetrics-gynaecology-journal.com/article/PIIS1751721412000425/abstract?rss=yesAbstract: In normal labour, the fetal head presents with the occiput in lateral position in early stages of labour followed by anterior rotation in advanced labour. Malpositions of fetal head result when the occiput persists in a lateral or posterior position while malpresentations occur due to extension of the fetal head causing brow or face to present. Malpresentations of fetal head are usually diagnosed in labour and are associated with difficult labour and increased risk of operative intervention. Regular systematic clinical examinations to monitor progress of labour and fetal wellbeing are necessary once the diagnosis is confirmed. Although vaginal delivery is possible in many cases, caesarean section becomes necessary when the malposition or malpresentation persists and labour fails to progress.Malpositions and malpresentations of the fetal headVikram S. Talaulikar, Sabaratnam Arulkumaran10.1016/j.ogrm.2012.02.011Obstetrics, Gynaecology and Reproductive Medicine 22, 6 (2012)2012-06-01Obstetrics, Gynaecology and Reproductive Medicine2012-06-01226S1751-7214(12)X0006-XReviews155161http://www.obstetrics-gynaecology-journal.com/article/PIIS1751721412000383/abstract?rss=yesAbstract: Osteoporosis is a growing health problem in the ageing population. A postmenopausal woman has an approximately 50% lifetime risk of suffering an osteoporotic fracture with hip fractures carrying the highest morbidity and mortality. Non-pharmacological prevention strategies focus on attainment and maintenance of a high peak bone mass and include a healthy lifestyle, nutritious and balanced diet, maintenance of optimal vitamin D level and physical exercise with skeletal mechanical loading. Pharmacological interventions include hormone replacement therapy in women with early menopause and postmenopausal women until the age of 60 in the absence of contraindications. Bisphosphonates (e.g. alendronate, risedronate and zoledronate) remain the mainstay of antiresorptive treatment and the novel biologic antiresorptive agent, denosumab is a safe option in patients intolerant or with contraindications to bisphosphonates. Anabolic therapy with PTH peptides is currently reserved for severe osteoporosis. A number of novel treatments e.g. cathepsin K inhibitors, calcilytic drugs anti-sclerostin antibodies are being assessed in clinical trials.Prevention and treatment of osteoporosis in women: an updateAnna Daroszewska10.1016/j.ogrm.2012.02.007Obstetrics, Gynaecology and Reproductive Medicine 22, 6 (2012)2012-06-01Obstetrics, Gynaecology and Reproductive Medicine2012-06-01226S1751-7214(12)X0006-XReviews162169http://www.obstetrics-gynaecology-journal.com/article/PIIS1751721412000395/abstract?rss=yesMaternal mortality represents one of the starkest disparities in health outcomes between developing and developed countries, the rich and the poor. An estimated 358,000 maternal deaths occurred worldwide in 2008 and over 8 million women suffer from illness, infection or injury as a consequence of pregnancy or childbirth. These estimates are likely to be underreported. With 99% of deaths occurring in the developing world it comes as no surprise that the majority of these deaths are preventable and that progress towards Millennium Development Goal 5 “the reduction of maternal mortality by 75% by 2015” is stalling. Despite low maternal mortality from pre-eclampsia in the developed world, pre-eclampsia contributes to 10–15% of these deaths worldwide; an estimated 50,000 women die annually from complications associated with pre-eclampsia. Moreover, it is thought that pre-eclampsia and eclampsia are associated with one quarter of stillbirths and neonatal deaths in developing nations.Preventing the preventable: pre-eclampsia and global maternal mortalityNatasha L. Hezelgrave, Shane P. Duffy, Andrew H. Shennan10.1016/j.ogrm.2012.02.008Obstetrics, Gynaecology and Reproductive Medicine 22, 6 (2012)2012-06-01Obstetrics, Gynaecology and Reproductive Medicine2012-06-01226S1751-7214(12)X0006-XEthics/Education170172http://www.obstetrics-gynaecology-journal.com/article/PIIS1751721412000565/abstract?rss=yesSelf-assessmentAlec McEwan10.1016/j.ogrm.2012.02.012Obstetrics, Gynaecology and Reproductive Medicine 22, 6 (2012)2012-06-01Obstetrics, Gynaecology and Reproductive Medicine2012-06-01226S1751-7214(12)X0006-XSelf-Assessment173175