Foreword
Sarah L Berga, MD, is Professor and Chairman of the Department of Obstetrics and Gynecology, Vice President of Women’s Health, and Associate Dean of Women’s Health Research at Wake Forest Baptist Medical Center. Dr Berga is active clinically in treating couples with infertility, women with endocrine disorders, and menopausal women. Dr Berga is a member of several professional societies including The Endocrine Society, the Society for Gynecologic Investigation, the American Society for Reproductive Medicine, and the Society of Reproductive Endocrinology and Infertility. Dr Berga performed her fellowship in reproductive endocrinology at the University of California, San Diego School of Medicine, residency in obstetrics and gynecology at Harvard Medical School and Massachusetts General Hospital, and graduated from the University of Virginia School of Medicine.
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elcome to this issue of US Obstetrics & Gynecology. Once again, we are proud to present this excellent collection of timely articles on many of the most important and interesting current topics in obstetrics and gynecology, with the aim to educate and inform physicians and their colleagues. Obstetrics and Gynecology continues to be a fast-moving and fascinating area, where original ideas continually lead to exciting clinical breakthroughs that are advantageous for practitioners and patients alike. This journal aims to highlight some of the areas where such progress has been made. As specialists in reproductive medicine, we have a burgeoning appreciation of the opportunities to advance the care of women, and men, by developing sex-specific strategies for identifying and treating conditions common to both sexes such as heart disease and osteoporosis. The Organization for the Study of Sex Differences has launched an electronic journal entitled The Biology of Sex Differences, with the goal of fostering a better understanding of the molecular, cellular, and physiologic basis of sex differences and holds an annual meeting devoted to explicating sex and gender differences in health and disease. The main concept is that every cell has a sex and the sex chromosomes contain information that modulates protein and other signaling molecules. Thus, cardiomyocytes that are male respond to anoxic insults and stressors differently to female cardiomyocytes.
This issue opens with an interesting look at current and future treatments of endometriosis. This article examines where we are currently with the treatment of this condition as well as the outlook for the future. New formulations of hormonal and anti-inflammatory drugs used in combination may bring positive outcomes for women suffering with this endometriosis. In the Assisted Reproduction and Infertility section, an article discussing male factor infertility looks at how an assay which measures sperm DNA fragmentation could play a part in helping to achieve successful pregnancy. Moving onto Maternal–Fetal Medicine, obstetric imaging in obese women is discussed. Obstetric imaging plays an important role in the assessment and management of obesity-related complications, and yet has significant limitations in quality and accuracy due to obesity itself. Another paper reviews the current state of our knowledge of the effects of prenatal maternal depression on fetal development, mediated by fetal exposure to maternal stress hormones. Transmission of risk from depressed mother to child may be mediated through inheritance of genetic risk, in utero exposure to stress hormones, and dysfunctional postpartum caregiving practice. In the Pre-term Labor and Delivery section, authors examine targeting immune activation in the prevention of pre-term labor. We also take a timely, in-depth look at human papillomavirus (HPV) in obstetrics and gynecology. One article looks at the current vaccination programs for certain strains of the virus and suggests ways in which these can be improved to reduce the overall rate of infection. Another article examines the potential for self-screening for HPV and the possibilities of this as a viable and accurate option for women in countries without the healthcare infrastructure to support standard screening programs. This section also looks at dynamics of HPV testing and cervical cancer screening, concluding that screening will likely become superfluous if long-term vaccines and vaccination programs are developed. Finally, this issue concludes with an article on breast health which looks at the management of benign breast diseases. This article aims to impart a working understanding of benign breast disease as a basis for clinical management of symptoms, distinguishing benign from malignant disease and identification of high-risk lesions.
Women’s health continues to be an interesting area and we hope you find this collection of articles to be thought-provoking and informative. On behalf of US Obstetrics & Gynecology I would like to thank all of the authors, reviewers, media partners and editorial board members for their support and commitment to making this issue such a valuable resource. n
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© TOUCH BRIEFINGS 2011
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