The Obstetrician & Gynaecologist 10.1111/tog.12561 http://onlinetog.

org Editorial

Editorial
It is with pleasure that I welcome several more new Many of us joke about ‘health and safety’ while not Editorial Board
Associate Editors to our Board. The quality of The realising the risks to ourselves and our teams from Kate Harding FRCOG
Guy’s and St Thomas’ NHS Foundation
Obstetrician & Gynaecologist (TOG) depends equally on toxins at work, such as surgical smoke. Addley and Trust, London
the papers that are submitted and the work done by the Quinn have detailed the risks from this surgical Mohamed Abdel-Fattah FRCOG
Associate Editors and our reviewers, without whom we by-product and the measures that should be taken to University of Aberdeen, Aberdeen

could not produce papers that are both well written and reduce exposure. I recommend that you read this George Attilakos MD MRCOG
University College London Hospitals NHS
of educational value. I thank all of you. Review and then apply its recommendations to your Foundation Trust, London
You may be aware of changes that are about to occur surgical settings. Shagaf Bakour MD FRCOG
City Hospital, Birmingham
(or have already occurred, depending on when you read We have two papers relating to poor pregnancy
Evelyn Ferguson
this Editorial). In spring 2019 there will be a major outcome. The first of these is on placental histology and NHS Lanarkshire
change in how the Royal College of Obstetricians and interpreting the findings. I recommend this paper to all of Kannamannadiar Jayaprakasan
Gynaecologists (RCOG) supports us through our us who send off the placenta and then do not understand Royal Derby Hospital, Derby

continuing professional development (CPD), of which the report. Hopefully after reading this excellent paper by Swati Jha MD FRCOG
Sheffield Teaching Hospitals NHS Foundation
TOG is a part. Please read the Commentary from Thirumalaikumar et al. you will be able to better advise Trust, Sheffield
Rosemary Howell, which clearly lays out the reasons for your patients in the future. I am delighted to have been Justin Konje FMCOG (Nig) FWACS MRCOG
University of Leicester, Leicester
the changes and how to access the new format. Having able to persuade Professor Lucas to share his lifelong (Lead CPD Editor)
seen how the CPD app is going to work, I am convinced interest and knowledge of maternal autopsy with us: he Bid Kumar FRCOG
that it will make our lives easier as we will be able to has probably done more maternal autopsies than any Wrexham Maelor Hospital, Wrexham

input data (via our phones) on meetings attended and other pathologist in the developed world. In his article, he Mohamed Mehasseb MD PhD MRCOG
Glasgow Royal Infirmary, Glasgow
reflections there-on as we travel home, rather than shares with us his understanding of the process of
Jo Morrison BM BCh MA MRCOG DPhil (Oxon)
trying to remember to do so just before our appraisal! organising an autopsy in the UK and what may be found Musgrove Park Hospital, Taunton
I am often asked why we do not publish the answers from this investigation (and thus how it contributes to Nicola Mullin MFFP FRCOG
to TOG CPD questions. Let me explain. The questions our and the families’ understanding of what led to the Countess of Chester Hospital NHS
Foundation Trust, Chester
are a way of demonstrating that the article has been death of the individual). Surabhi Nanda MRCOG
read, thus not only are all the answers embedded in the The article on the long term use of corticosteroids in Guy’s and St Thomas’ NHS Foundation Trust,
London
related paper but they are directly drawn from the paper pregnancy by AlSaad et al. will be of interest. Many
Nikoletta Panagiotopoulou MD MRCOG
and are often very specific in their details (e.g. asking in women are prescribed steroids in pregnancy for a range of Royal Victoria Hospital, Belfast
what percentage of the population an event occurs). If medical conditions, from asthma to immunosuppression Asha Shetty MD FRCOG
we published the answers, we would have to remove the for transplantation. In most of these conditions it is vital Aberdeen Maternity Hospital, Aberdeen

questions from the CPD credits file, otherwise the not to stop (or even reduce) steroid prescription, so an Thomas Tang MD MRCOG
Regional Fertility Centre, Royal Maternity
process becomes meaningless. More challenging understanding of the pharmacokinetics of different types Hospital, Belfast
questions can be found in TOG’s single best answer of steroids and how this changes with gestation and Ephia Yasmin MRCOG
questions, available on the RCOG eLearning pages. placental transfer is of importance. This article clearly University College London Hospitals NHS
Foundation Trust, London
These do not lead to CPD credits, but the answers are explains the potential risks to both the mother and the
Wai Yoong MD FRCOG
provided after the question is attempted. fetus from steroid exposure, discusses the need for fetal North Middlesex University Hospital, London
With the lengthening of daylight hours, at least in steroids, even in those on long term oral steroids, and Bassel Wattar (Trainee Representative)
the UK, many of us will consider increasing our physical discusses the use of extra steroids around delivery to University of Warwick

activity. While this undoubtedly has benefits to our prevent an Addisonian crisis. Alison Richardson MBChB MRCOG PhD (Trainee
Representative)
overall health, for some women extreme exercise As well as all our review articles, we have our usual Leeds Teaching Hospitals NHS Trust, Leeds
regimes can have detrimental affects on their physiology. extras such as ‘And finally. . .’, an article from Marian
The article on sports gynaecology by Jones et al. Knight on recent findings from UKOSS and a selection International Advisory Board
describes the underlying physiological and clinical of book and app reviews. I hope you enjoy reading this Richard Brown MBBS DFSRH FRCOG FACOG
impacts of extreme exercise, and thus low ‘energy edition of TOG as much as we have enjoyed putting McGill University Health Centre, Montreal, Canada

availability’, on menstrual function, fertility and bone it together. Amr El-Shalakany MSc MD FRCOG
Ain Shams University Maternity Hospital,
mass. This article will be of help to those of us Cairo, Egypt
investigating women presenting with menstrual €f
Sebastian Gidlo
dysfunction or subfertility, be they professional Stockholm South Hospital, Sweden

sportswomen or adolescents dreaming of a future as an Carman Lai MRCOG FHKCOG FHKAM (O&G) Cert RCOG
(Maternal and Fetal Medicine)
elite gymnast. Queen Mary Hospital, University of Hong
Kong, Hong Kong
Henry Murray MRCOG
Australia
N Rajamaheswari MD DGO MCh (Urology)
Director, Urogynaecology Research Center
Pvt Ltd, India

Editor-in-Chief Duru Shah MD FCPS FICS FICOG DGO DFP FICMCH

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

Kate Harding
David Shaker FRCSEd FRCOG FRANZCOG
University of Queensland, Rockhampton
Base Hospital and Mater Private Hospital,
Australia
Jason Waugh MRCOG (Emeritus Editor)
Auckland, New Zealand

ª 2019 Royal College of Obstetricians and Gynaecologists 79