Frank Sharp – författare

The first few months of any pregnancy are of supreme importance to the success of that pregnancy. This statement is so obvious as to be almost a platitude, yet it must be said that no aspect of pregnancy has been more neglected in the human than the first three months. Little is known of the morphological changes that occur at that time and our knowledge of the mechanisms that control this vital stage of pregnancy is almost non-existent. The explanation for this neglect of what is an obvious area for study is the difficulty of obtaining normal material. It is rare to have material to study from a healthy first trimester pregnancy and the study by Hertig and Rock!l) of early conception found by chance in hysterectomy speci­ mens must be unique. The information that we do have about early pregnancy is mostly gained from animal studies or single miscarriages in humans. Chromosomal defects are common but are not an explanation for the majority of recurrent miscarriages. Obstetricians have hypothesised many causes for this condition and have deve­ loped numerous metQods for treating it, but the studies have been poorly con­ trolled so that our understanding of the cause(s) has not advanced. Treatment of women with a history of recurrent miscarriage by paternal leuco­ cyte infusion (immunotherapy) may be yet another form of treatment that is hailed as a new advance only to be rejected when subject to rigorous testing.

The first few months of any pregnancy are of supreme importance to the success of that pregnancy. This statement is so obvious as to be almost a platitude, yet it must be said that no aspect of pregnancy has been more neglected in the human than the first three months. Little is known of the morphological changes that occur at that time and our knowledge of the mechanisms that control this vital stage of pregnancy is almost non-existent. The explanation for this neglect of what is an obvious area for study is the difficulty of obtaining normal material. It is rare to have material to study from a healthy first trimester pregnancy and the study by Hertig and Rock!l) of early conception found by chance in hysterectomy speci­ mens must be unique. The information that we do have about early pregnancy is mostly gained from animal studies or single miscarriages in humans. Chromosomal defects are common but are not an explanation for the majority of recurrent miscarriages. Obstetricians have hypothesised many causes for this condition and have deve­ loped numerous metQods for treating it, but the studies have been poorly con­ trolled so that our understanding of the cause(s) has not advanced. Treatment of women with a history of recurrent miscarriage by paternal leuco­ cyte infusion (immunotherapy) may be yet another form of treatment that is hailed as a new advance only to be rejected when subject to rigorous testing.

This book is based on the 20th Study Group of the Royal College of Obstetricians and Gynaecologists, which concerned the important topic of fetal growth. Basic scientific, and both obstetric and paediatric aspects of the subject were addressed in contributions from many different disciplines, and we are greatly indebted to all the international experts who took part in this workshop at the RCOG in London in November 1988. The deliberations covered the broad topics of normal fetal growth, fetal over­ growth and undergrowth. Clinical implications of these entities, especially fetal undergrowth, played a large part in the proceedings as dictated by c.1inical con­ cerns. Definitions, epidemiology, aetiology and screening were covered, as were technological developments, with special reference to blood flow and volume flow measurements, both fetal and placental. Other aspects of clinical fetal monitoring, including fetal activity measurement, and biophysical evaluation were rationalised and placed in context, and the important newly emerging areas of cordocentesis and therapy in IUGR addressed. Finally, neonatal management of the SGA baby, mortality and long-term morbidity were considered.

This book is based on the 20th Study Group of the Royal College of Obstetricians and Gynaecologists, which concerned the important topic of fetal growth. Basic scientific, and both obstetric and paediatric aspects of the subject were addressed in contributions from many different disciplines, and we are greatly indebted to all the international experts who took part in this workshop at the RCOG in London in November 1988. The deliberations covered the broad topics of normal fetal growth, fetal over­ growth and undergrowth. Clinical implications of these entities, especially fetal undergrowth, played a large part in the proceedings as dictated by c.1inical con­ cerns. Definitions, epidemiology, aetiology and screening were covered, as were technological developments, with special reference to blood flow and volume flow measurements, both fetal and placental. Other aspects of clinical fetal monitoring, including fetal activity measurement, and biophysical evaluation were rationalised and placed in context, and the important newly emerging areas of cordocentesis and therapy in IUGR addressed. Finally, neonatal management of the SGA baby, mortality and long-term morbidity were considered.

AIDS continually presents new questions for the obstetrician and gynecologist. The effect on pregnancy, the possibility of perinatal transmission, HIV positive tests, and risk to staff are just a few of the issues confronting clinicians and practitioners today. These and other questions were addressed by the 19th Study Group of the Royal College of Obstetricians and Gynaecologists, whose findings are reported here.

AIDS continually presents new questions for the obstetrician and gynecologist. The effect on pregnancy, the possibility of perinatal transmission, HIV positive tests, and risk to staff are just a few of the issues confronting clinicians and practitioners today. These and other questions were addressed by the 19th Study Group of the Royal College of Obstetricians and Gynaecologists, whose findings are reported here.

The Helene Harris Memorial Trust has become recognized as providing one of the most important international fora for the presentation of research in ovarian cancer. Four biennial meetings have taken place, the most recent of which was held between May 11-14, 1993, in Toronto, Canada. This forum has grown in stature from its inception in 1987 and has brought together interdisciplinary clinical and scientific researchers from around the world who are endeavouring to perform ''cutting edge'' studies in the field. The assembled group of presti­ gious investigators met on this occasion to present their data, to exchange ideas, and to arrange collaborations with the goal of developing new means of detection, treatment and cure of ovarian cancer. The incentive for the establishment of the Trust and its international forum was the prema­ ture loss through ovarian cancer of Helene Harris, the wife of Mr John Harris. Mr Harris and the Trustees looked for a meaningful way to honour the memory of Helene and to advance the noble cause of gaining an increase in the scientific knowledge of the subject. For those of us who spend most of our waking hours assisting patients and their families who are devastated by this disease, the Trust''s generosity provides inspiration, hope and the opportunity for their practical application in a unique professional forum.