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October 28, 1983

Reid's Controversy in Obstetrics and Gynecology—III

Author Affiliations

Massachusetts General Hospital Harvard Medical School Boston

JAMA. 1983;250(16):2218. doi:10.1001/jama.1983.03340160094047

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Zuspan and Christian have admirably fulfilled their purpose to provide an enlightened exposition on current controversies in obstetric and gynecologic practice. To do this, they have enlisted an articulate group of contributing authors.

Discussion of the management of carcinoma in situ of the cervix represents well-substantiated, extreme points of view. The middle ground between cancer precursors and the infectious origin of dysplasia needs more investigation. Conversely, those authors discussing obstetrical problems such as prenatal fetal monitoring and the management of preterm labor explore the middle ground of controversy in depth. Here it is clear that clinical trials of sufficient size and statistical power cannot be mounted to provide definitive answers. The shrewd application of new understanding of pathophysiology is well presented and critically evaluated, but the editors are too timid about exercising their prerogative. One does not need to reread the litany of obstetricians' current understanding of the sympathetic nervous