Welcome back to the autumnal issue of TOG. As we all come down from the summer holiday highs of Olympic triumphs and mop up from the UK's torrential rain, I'm drawn to ponder on what lies in store on the countdown to Christmas!

What will be on everyone's mind as the nights draw in? Maternity pathways, payment by results, specialist commissioning, or maybe the imminent arrival of appraisal for revalidation? Well if it's the latter then I would hope that this issue will again have something for everyone when it comes to the knowledge based assessments; it's an issue packed with broad based reviews – though with a little more gynaecology than usual.

The editorial board has to consider numerous abstracts when it comes to commissioning articles and the process hopefully results in a fair and balanced mix of papers that are published. I think that the reviews in the gynaecology section this time are testament to that process. It could have been fairly easy to dismiss the review by Damigos and colleagues on ovarian torsion (page 229) with the assumption that “little can have changed here since I was at medical school”. How wrong could you be? This review covers new diagnostic modalities as well as alternative treatment options and not only serves as good CPD for all with acute gynaecology portfolios, but I was also struck by its relevance to training for speciality trainees and it now forms the basis for a fantastic cased-based discussion – even for me, a non-gynaecologist.

On the basis that “common things are common” it should also mean that the two reviews from Molly Carey and Rebecca Allen on non-contraceptive uses and benefits of combined oral contraception (page 223) and Kwun and colleagues on the prevention and treatment of osteoporosis (page 251) will have a widespread appeal to generalists and subspecialists alike. The editorial board with its international membership means that international author groups may either submit abstracts or be suggested for direct commissions for TOG articles. I'm sure you will agree that these reviews are clear and comprehensive and we hope to continue to develop our international remit.

On the basis that ‘everyone likes a bit of controversy’, I'm grateful to Mark Roberts and Tracey Hughes for their discussion of who should perform the ultrasound examinations in gynaecology, on page 237. This is a very hot topic given the challenges facing us all not only as service providers, with a push for a ‘point of care/one-stop’ approach, but also as trainers for the new RCOG curriculum and the gynaecology ultrasound module. The article certainly doesn't have all the answers but it is a great starting point for discussion and a great read. This leads into our final gynaecology article, where Bakour and colleagues (page 243) provide an excellent review on the management of postmenopausal bleeding (PMB) and appraise the evidence relating to diagnosis and management of PMB

I'm sure I'll be ostracised from the obstetricians club when I tell you that the first of the two obstetric reviews has been written by a urogynaecologist (and colleagues). This is a fantastic review from Farah Lone, Abdul Sultan and Ranee Thakar on obstetric pelvic floor and anal sphincter injury (page 257) and is a must-read article.

The review from Lakhi and colleagues on maternal serum analytes as markers for adverse obstetric outcome (page 267) highlights the dilemmas that arise as more and more information becomes available regarding biomarkers that we already measure and obstetric outcomes outside those that the test was originally commissioned for.

To close on an unusual note, I thought I should give a mention to an RCOG sponsored project which is the brainchild of an OBGYN speciality trainee. Sophia Webster plans to fly solo from South Africa to the UK in an effort to raise public awareness of the recent WHO report highlighting those countries that are making slow progress towards the maternal mortality targets in Millennium Development Goal 5 (discussed in The Obstetrician & Gynaecologist 2011;13:259–62). After a summer of inspirational performances by Olympians and Paralympians, I was impressed that there are also individuals from other walks of life who are prepared to try to make a difference in other ways. Sophia will be at the FIGO World Congress to publicise her project and there's more information on her website (www.flightforeverymother.com). I'm not suggesting we all buy a Cessna but a bit of support might be appreciated.

I hope you all enjoy this issue and don't miss the latest in tips and techniques for a ventouse delivery from Tracey Johnston and Tara Selman on page 275.


Editorial board

Jason Waugh MRCOG

Royal Victoria Infirmary, Newcastle Upon Tyne

Mohamed Abdel-Fattah MRCOG

University of Aberdeen, Aberdeen

Jo Anthony MA FRCOG

Northampton General Hospital NHS Trust (Chair of the RCOG Revalidation Committee)

Kate Harding FRCOG

Guy's and St Thomas' NHS Foundation Trust, London

Justin Konje FMCOG (Nig) FWACS MRCOG

University of Leicester, Leicester (CPD Editor)

Kate Langford MA MD FRCOG

Guy's and St Thomas' NHS Foundation Trust, London

Kay McAllister DFFP MRCOG

The Sandyford Initiative, Glasgow

David Parkin MD FRCOG

Aberdeen Royal Infirmary, Aberdeen

Mark Roberts MD MRCOG

Royal Victoria Infirmary, Newcastle Upon Tyne

Thomas Tang MD MRCOG

Regional Fertility Centre, Royal Maternity Hospital, Belfastd

International advisory board


Private practice and Queen Mary Hospital, Hong Kong

Ki-Hong Chang MD PhD

Ajou University School of Medicine, Korea


Mercy Hospital for Women, Melbourne, Australia

Amr El-Shalakany MSc MD FRCOG

Ain Shams University Maternity Hospital, Cairo, Egypt

Gary Frishman MD

Warren Alpert Medical School of Brown University and Women & Infants Hospital of Rhode Island, USA

Henry Murray MRCOG


Dimitrios Koleskas MRCOG

Euroclinic, Athens, Greece


Jaslok Hospital, Sir Hurkinsondas Hospital and Breach Candy Research Centers, India


University of Queensland, Rockhampton Base Hospital and Mater Private Hospital, Australia


John Hunter Hospital, New South Wales, Australia

Dirk Timmerman MD PhD

University Hospitals Leuven, Belgium