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Obstetrics: Normal and Problem Pregnancies,

4th edition

Article in The Obstetrician & Gynaecologist January 2011

DOI: 10.1576/toag.5.3.187

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David Churchill
The Royal Wolverhampton NHS Trust
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The book covers issues regarding preconception
counselling and the management of women after
they have had pregnancy-induced hypertension
and the risks that this affords them long term.
Professor Walker makes a valiant attempt to
review antihypertensive therapy in pregnancy.
However, the reality is that our pharmacological
armamentarium has changed little over the last
ten years.
Obstetrics: Normal and Problem
Pregnancies, 4th edition
Editors Steven G Gabbe,Jennifer R Niebyl, Joe L Simpson
With so many ways of accessing information the
question arises, is the place of the major
reference textbook still relevant in the 21st
century? Their limitations are self-evident; they
are costly, the information is time-limited and
their size usually renders them relatively static
objects. A computer CD has none of these
drawbacks and the information can be updated
in a timely manner. However, paper has a reas-
suring solidity and it doesnt crash! Nevertheless,
how is the quality of such a book assessed and
how do large books stay relevant? I assessed the
book on four main criteria: presentation, how
easy it is to read, if it is up to date and how it
compares with the competition.
It is a multi-author book from the USA. Like its
predecessors and textbooks in general from the
USA it is comprehensive.The list of 59 authors
is impressive and all are recognised experts in
their fields. With this pedigree expectations of
the book should be high.The first edition of this
book was published in 1986 and the authors
state in the preface to this edition that extensive
changes have been made. Notably this involves
the addition of three new chapters on fetal
therapeutic interventions, surgical procedures in
pregnancy and endocrine diseases in pregnancy.
Although other changes have occurred these are
the most significant. However, the book
maintains the same format as the first edition.
The scientific foundations of obstetrics are
presented in the first few sections before the
clinical complications affecting obstetric medical
practice are discussed.
This book is well presented and, on the whole,
easy to read. The editors state in their intro-
duction that it should be possible to read a
chapter in an evening. This is undoubtedly true,
however, it may take somewhat longer to
The book is targeted at the relatively large BOOK REVIEWS
American audience but its contributions from
The Obstetrician
authors from other countries will make this
& Gynaecologist
book enjoyable and of considerable use to post-
graduates elsewhere in the world. I therefore
commend it for every departmental library.
Reviewer Mark D Kilby MI) MKCOC,
Professor of Fetal Medicine, Birmingham Womens
Hospital, Edgbaston, Birmingham B15 2TG,
UK.
assimilate all the facts.The book is well furnished
with plenty of informative tables, line drawings
and photographs to reinforce and emphasise the
important areas referred to in the text.
The information presented in the book is up to
date with the current literature and the evidence
is presented in a balanced way. New develop-
ments are frequently referred to in the text of
each chapter. There are many examples of the
books success in this regard. Many obstetricians
will have been getting to grips with the finer
points of managing HIV-positive women. The Churchill Livingstone, 2001
book comprehensively reviews the data on HIV ISBN 0443065721
Hardback, 1430 pages, 692.95
and if I had read this earlier it would have saved
me a lot of time.There are many other examples
to be found, such as in the chapters on fetal
therapeutic intervention, diabetes, preterm birth
etc.
As well as factual information the book provides
some insight into obstetrics in the USA. An
example of this is a copy of a consent form to be
found in the chapter on prenatal care, for trial of
labour/repeat cesarean section with all the risks
laid out for the patient. Likewise the chapter on
legal and ethical issues in obstetrics may send a
few shivers down the spine, given the propensity
for legal issues to transfer rapidly across the
Atlantic these days. One illustration of another
irritating international problem is the lack of
uniformity in scientific units. For example,blood
sugars measured in milligrams per decilitre
instead of millimoles per litre. Surely in 2002
with international communication never easier
harmonisation of scientific units is desirable.
Finally, if you are looking to update your major
textbook the choice is now larger than ever. If
you do buy this book rather than the com-
petition you will not be disappointed. However,
187
 BOOK REVIEWS it you are loolung tor a specihc detall or advice Keviewed by Uavid Churchill Mi<( OG,
-. . ___ ____
on a management issue be prepared to invest Consultant Obstetrician, Good Hope Hospital,

The Obstetrician
Gynaecoogist
time in reading each section. A quick skim to
find the relevant information will not work. As
Rectory Road, Sutton Coldfield, Birmingham,
B75 7RR, UK.
for the four tests I think that the book passes
with credit.

A Guide to the Polycystic Ovary

Authors Gabor Kovacs, Jane Smith
Professor Gab Kovacs and Jane Smith have
written an extremely clear book on the polycystic
ovary syndrome for patients.The book is just over
100 pages long and provides some background on
the history and epidemiology of the syndrome,
the bases of ovarian physiology and the
abnormalities that are seen in the polycystic ovary
syndrome (PCOS). Careful attention is paid to
the relevance of PCOS to insulin resistance and
---.-.-......--.--
I-^-...-.&-
suggests that ultrasound monitoring d both
ensure that an adequate response has been
achieved without putting the patient at increased
risk of multiple pregnancy.The remainder of the
chapter on ovulation induction specifically refers
to practice in Australia but is also highly relevant
to the UK and European population.The careful
description of laparoscopy would be of great
benefit to patients not only undergoing laparo-

--...*.--- metabolic problems. PCOS is a diverse condition scopic ovarian surgery but also diagnostic
--------._---
----.I

-.---*-I--
that effects women in different ways at different laparoscopy for other reasons. The use of insulin
times in their lives and the authors should be sensitising agents such as metformin and the
-_.---_I

TFM Publishing Ltd, 2002
ISBN 1903378060
Paperback, 120 pages, 69.99
congratulated for providing a clear account of the
various aspects of the condition. Pragmatic advice
is also given on lifestyle changes with sensible
guidance on diet - a subject on which much has
been written in the lay press and on websites for
PCOS, but little is based on true scientific
foundation. Alongside pragmatic advice, clear
descriptions are provided of the various treat-
ments available for all aspects of PCOS. Indeed,
there is an interesting section on surgery for
obesity. There are some places were practice
differs from that in the UK, for example, in the
monitoring of clomiphene citrate therapy for
ovulation induction where the use of temperature
charts have been suggested as providing a
guestimate of ovulation. These days we have
largely moved away from temperature charts and
both the Royal College of Obstetricians and
Gynaecologists and British Fertility Society
Guidelines for the use of clomiphene citrate
glitazones (thiazolidinediones) are mentioned in
passing with sensible caution regarding the lack of
evidence from large studies.
In conclusion, this is an extremely well written
and readable book that d be of great benefit to
women with PCOS and also to health care
professionals (e.g. nurses, deticians and ultra-
sonographers) who have regular contact with
patients with the condition. In view of the fact
that PCOS is the most common endocrine
disturbance to S e c t women, a copy should be
available in every gynaecology clinic and every
general practitioners waiting room.
Reviewer Adam H Balen MI) MRVOG,
Consultant Obstetrician and Gynaecologist, IVF
Unit, Leeds General Infirmary, Belmont Grove,
Leeds, LS2 9NS, UK.

Inhibin, Activin and Follistatin in Human

- *rurdlepna
Imperial College Press, 2002
ISBN 0860942059
Hardback, 340 pages, 650.00
Reproductive Physiology
Editors Shanti Muttukrishna, William Ledger
A water-soluble testicular principle first
described in 1932,gene-sequenced and expressed
as a bioactive protein in the mid-l980s, developed
into a diagnostic test in the 1990s: inhibin as a
hormone has come of age. Basic and clinical
research interest in inhibin and its stablemate
activin has exploded over the last 20 years, with
the PubMed database now throwing up close on
4700 entries when searched for inhibin OR
activin.Therefore,to those of us without the time
to read even a fraction of the primary scientific
literature on the subject, ths collection of review
articles is a most welcome arrival.
Aimed principally at the postgraduate researcher,
the eleven chapters deal comprehensively with

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