Fetal radiology is rapidly evolving from a conventional clinician supporting diagnostic approach, focused on congenital and structural malformations and serial growth assessments, to an inclusive, proactive, and holistic preventative and prognostic approach focused on optimizing therapeutic interventions and fetal outcomes. Multi modality sequential exams allow fetal radiologists to recommend and provide evidence based protocols for early identification and therapeutic and prognostic information leading to earlier interventions besides providing confirmatory evidence for the presence or absence of factors that may affect fetal or maternal well-being.
However, these changes do not mean much if they do not translate into action for two major populations a) the vast majority of fetal radiologists who work in individual or small group settings without much institutional support and b) every pregnant woman irrespective of their Socio-Clinico-Demographic status. Changes acquire their true meaning when they are used by many for the benefit of many.
There is a need to increase awareness of and promote, encourage and advocate for the translation of pragmatic, doable, evidence based solutions. Simultaneously, there is a real need to encourage discussions around alternate solutions based on local knowledge, skills, context and realities. This may require scaling down from an ideal practice based on perfect evidence to an acceptable practice based on pragmatic reality and formed on the premise that the new practice will set in motion frameworks for improved outcomes. In a sense, this reflects the ability to adapt evidence into workable solutions at all levels of healthcare, which is essential if the benefits are to reach everyone.
Translating and acting on evidence is not enough as medical practice is a dynamic field. There is a need for constant evaluation of what works well and what does not, what can be improved and why and how. Such evaluation should consider the perspectives of every fetal radiologist including those working in non institutional settings and who practise their craft with minimal, if any, support systems. Equally important, if not more important, is an evaluation based on what the new practices mean for every pregnant woman and fetus, arguably the most important stakeholders in fetal radiology.
The Journal of Fetal Radiology aims to share pragmatic, user and context based, solutions to common everyday clinical issues that affect the vast majority of fetal radiologists and pregnant women in India and similar countries. The Journal focuses on a pyramid model that recognizes that majority of problems are at the base of the pyramid and hence proposes sharing knowledge from the ground up that can drive hypotheses driven research of practical and pragmatic value. The Journal also proposes to listen and share the voices of others involved with fetal care- the pregnant woman, ethicists, policy makers, sociologists, health educators, innovators and product developers, amongst others.
The Journal of Fetal Radiology is inclusive and has only one major purpose. To share and learn together from pragmatic and contextual evidence that can be applied by the many for the benefit of the many. To achieve this purpose, the Journal of Fetal Radiology is designed as an open access Journal that encourages viewers to use, adapt and share information with others.
Dr. Rijo Mathew Choorakuttil
Editor in Chief