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An overview is given on the scientific education of the Trainees (Specialists in Training in Europe). European legislation is clear and insists on the scientific formation in the undergraduate as well as in the Postgraduate education. It is the task of the national (or regional) authorities to create possibilities for research during clinical training. In most of the national training programmes Research activities are included. Moreover in the European visiting system Research facilities are an important item. Examples are shown how the Royal College of Obstetricians and Gynaecologists (U.K.) and the European Board and College of Obstetrics and Gynaecology have implemented these Research activities in the training programme.

The foetal growth is, for the greater part, determined genetically. There are, however, favouring and inhibiting factors, which influence this growth. In such a matter, the mother, the placenta and the foetus play an important part. The mother shows as well metabolic as vascular adaptations. The placenta must let through nutrients and oxygen; the uteroplacental circulation is characterized by a high flow, together with a low vascular resistance. The foetus itself plays an important part owing to its own growth factors. The principal growth factors are insulin and the growth factors analogous to insulin. The slowing up of the intra-uterine growth is the consequence of genetic factors or of the decrease of the growth-potential. The real cause is, however, mostly a decrease of the vascular adaptation in the mother or a diminution of the uteroplacental circulation. The vascular causes usually induce an asymmetrical delay in the growth; foetal causes induce a symmetrical retardation. An exaggerated growth of the foetus--or macrosomy--is mostly due to an excessive inflow of nutrients: this is the case when a pregnant woman is suffering from diabetes. During the former years, it has become evident that abnormalities of the foetal growth influence the later life of people.

Diabetes and pregnancy are associated with an increased incidence of preeclampsia. The pathogenesis is not exactly known. However endothelial factors and more special the prostacyclin-thromboxane system may be involved. Perinatal morbidity and mortality is increased in a diabetic pregnancy implicated with preeclampsia. Prevention and a curative approach is necessary.

Perinatal medicine is mostly interested in the normal development of the growing fetus. Perinatal care is becoming even more important, since a disorder in fetal development, due to an abnormal intrauterine milieu, results in problems during infancy and adult age. There is clear evidence that this is the case in diabetes and pregnancy and in intrauterine growth retardation.

During normal pregnancy vascular and hemodynamic changes are present. These alterations are due to a change in the balance between prostacyclin and thromboxane in favour of prostacyclin. In pregnancy induced hypertension the balance is in favour of thromboxane, explaining the absence of the vascular adaptation of pregnancy. Pharmacologic approach to restore the balance in favour of prostacyclin are promising.