Antibiotic prophylaxis before amniocentesis.

We are writing to make your readers aware of events stemming from a published Letter to the Editor in Prenatal Diagnosis (Ferrazzi, 2010) that has led to actions that could appreciably threaten our future ability to discuss and pose questions about methods chosen and conclusions drawn by authors of published papers. In a Letter to the Editor, Professor Enrico Ferrazzi (Ferrazzi, 2010) asked some important questions about the methodology, informed consent, oversight, and follow-up procedures in a study by Giorlandino et al. (2009) that involved the use of antibiotics to diminish procedure-related fetal loss following second trimester amniocentesis. The study had been a subject of a previous Letter to the Editor (Alfirevic and Pilu, 2009), who had suggested that the study results ‘must be interpreted with caution’. In his letter, Professor Ferrazzi addressed some other aspects of the study, and he requested that the authors provide additional information for clarification. Unfortunately, this triggered a lawsuit against Professor Ferrazzi, filed in an Italian court by Professor Giorlandino, based on the contention that the letter caused ‘moral damages’, and that it resulted in a loss of revenue for the private corporation headed by Professor Giorlandino. Letters to the Editor represent invaluable avenues for open exchange of ideas and investigative debate that often reflect directly on patient care. This has long been a part of the scientific process, which also includes an internal review of the letter itself. Specifically, Letters to the Editor allow members of the scientific community to openly comment, criticize, and seek clarification on what has been reported in original articles. In essence, it has epitomized academic freedom at work. The common practice has been for authors simply to address in print the concerns of the letter writer, and then to move on. In this case the response was not just to answer (Giorlandino et al., 2010), but to sue. This response to a letter of scientific query could dissuade, if not completely stifle anyone’s desire to question in print ANY published paper. We believe that academic leaders, the editors of scientific journals, and the academic community at large, should be aware of what is transpiring in Italy, and be alert to the potentially chilling implications of this lawsuit. We believe that Prof. Ferrazzi is entitled to write a letter to the editor expressing his concerns, and we sincerely hope that this anomalous response to a legitimate scientific inquiry will go no further. JohnC.Hobbins, Gianluigi Pilu, Alfred Abuhumad, Zarko Alfirevic, Ray O. Bahado-Singh, Beryl R. Benacerraf , Richard L. Berkowitz, Irene Cetin, Joshua A. Copel, Sturla Eik-Nes, Tiziana Frusca, Henry L. Galan, Secondo Guaschino, Maurice J. Mahoney, Karel Marsal, Gustavo Malinger, Anna Maria Marconi, Pasquale Martinelli, Thomas R. Moore, Aris T. Papageorghiou, Lawrence D. Platt, Nicola Rizzo, Ann Tabor, Baskaran Thilaganathan, Ilan E. Timor-Tritsch, Tullia Todros and Simcha Yagel Department of Obstetrics and Gynecology, University of Colorado Denver, Aurora, CO, USA Department of Obstetrics and Gynecology, University of Bologna, Italy Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, VA, USA Division of Reproductive and Perinatal Medicine University of Liverpool, Liverpool, Liverpool Women’s Hospital, Liverpool, Merseyside, England Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI, USA Diagnostic Ultrasound Associates, Boston, MA, USA Columbia University, Department of Obstetrics and Gynecology, New York, NY, USA Department of Obstetrics and Gynecology, University of Milan, Italy Department of Obstetrics and Gynecology, Yale University, New Haven, CT, USA National Center for Fetal Medicine, St. Olav’s Hospital, Norwegian University of Science and Technology, Trondheim, Norway Department of Obstetrics and Gynecology, University of Brescia, Italy Department of Obstetrics and Gynecology, University of Trieste, Trieste, Italy Yale University, Department of Obstetrics and Gynecology, Stratford, CT Department of Obstetrics and Gynecology, Clinical Sciences Malmö, Lund University, University Hospital MAS, Malmö, Sweden Department of Obstetrics and Gynecology, Tel Aviv University, Tel Aviv, Israel AOU, Department of Obstetrics and Gynecology, University of Naples, Italy Department of Obstetrics and Gynecology, University of California, San Diego, San Diego, CA, USA Fetal Medicine Unit, St. George’s University of London, London, England Professor of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA