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Evidence-based medicine can be a two-edged sword. How does the busy practitioner keep up with many innovations that seemingly appear daily into our clinical literature Who is the arbiter of their incorporation into clinical obstetrics Should observations that satisfy the mathematical definition of statistical significance, but that have limited clinical significance, be employed nationwide as the "standard of care" To us, the obvious answer is "no." And so we applaud our professional organizations such as the American College of Obstetricians and Gynecologists for their pragmatism and wisdom in recommendation of protocols for clinical management that inevitably do become the "standard." For our part, in this book we have attempted to perform a balanced review of the literature to present readers with pros and cons of different management methods so that they may select options that are best suited to their available resources. We have also tried to avoid dogmatism which unfortunately dominated the practice of obstetrics for several decades of the 20th century. At the same time, we are proud to be associated with academic teaching services that are disciplined examples of evidence-based obstetrics. Although none of these services is perfect in any sense of the definition, we draw heavily on our combined clinical observations when recommending management options. We do however emphasize that these recommendations do not necessarily represent a sole method of management.
