We’re in a much different position than we were 50 years ago in that we have two patients – the mother and the fetus – with whom we can closely work. We also have a relatively new and urgent obligation to place our attention not only on women’s reproductive health, but on the general gynecologic state. Ob.gyns. often are the only primary care physicians whom women see for routine care, and the quality of our attention to their weight and their diabetes risk factors will have far-reaching consequences, both for them and for their offspring.
As we have since the 1960s, we will continue to set new moonshots and meet new challenges, working with each other and with our patients to evaluate where we are strong and where we must improve. We will persistently harness the power of technology, choosing to do the things that “are hard,” while stepping back as needed to ask and address fundamental questions.
As a result, I can envision the next 50 years as a revolutionary time period for obstetrics – a time in which current problems and disorders are abated or eliminated through a combination of genomics, microbiomics, and other technological advances. Someday in the future, we will look back on some of our many achievements and marvel at how we have transformed the unimaginable to reality.
Dr. Reece, who specializes in maternal-fetal medicine, is vice president for medical affairs at the University of Maryland, Baltimore, as well as the John Z. and Akiko K. Bowers Distinguished Professor and dean of the school of medicine. Dr. Reece said he had no relevant financial disclosures. He is the medical editor of this column. Contact him at obnews@frontlinemedcom.com.
Select advances through the years
1960s
1965: Siemens Corp. introduces first real-time ultrasound scanner.
1966: Lancet paper reports that amniotic fluid cells can be cultured and karyotyped.
1970s
1970: New England Journal of Medicine paper describes mid-trimester amniocenteses and detection of Down syndrome cases.
1972: Ultrasound-guided amniocentesis first described.
1973: Fetoscopy introduced.
1980s
1981: First human open fetal surgery to correct congenital hydronephrosis.
Early 1980s: Chorionic villus sampling introduced at select centers.
1985: Color Doppler incorporated into ultrasound.
1990s
1990: Embryoscopy first described.
Mid-1990s: 3D/4D ultrasound begins to assume major role in ob.gyn. imaging.1997: Discovery of cell-free fetal DNA in maternal plasma.
2000s
2003: MOMS (Management of Myelomeningocele Study) was launched.
2010s
2012: The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine support cell-free DNA screening for women at increased risk of fetal aneuploidy.
2013: Preterm birth rate drops to 11.4%
2014: Diabetes incidence marks a 4-fold increase since 1980.