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Overview
Directed towards medical specialists who care for fetal patients, including general obstetricians, neonatologists, genetic counselors, pediatric surgeons, perinatologists, pediatricians, pediatric subspecialists, obstetric anesthesiologists, and pediatric anesthesiologists. This textbook contains all aspects of these cases, from pharmacology and physiology of the fetal patient and mother to specific techniques for open surgery, fetoscopic surgery, and EXIT procedures. By addressing and clarifying these issues, Anesthesia for Fetal Intervention and Surgery contributes greatly to a cohesive approach to the management and treatment of the fetal patient.
Synopsis
In introducing these dozen chapters, anesthesiologists Myers and Bulich (both with Harvard Medical School; Advanced Fetal Care Center, Children's Hospital, Boston) point out that in utero surgical intervention for fetal repair has only recently became a reality and subspecialty. They emphasize that new surgical techniques involving more than one patient simultaneously require new anesthetic techniques. International contributors identify what is currently known about normal and abnormal fetal development, and knowledge gaps in regard to treating pre-birth patients with congenital disorders. Challenges include knowing when pain is first felt, and earlier detection of such conditions as cardiac defects. Illustrations feature surgical techniques. Annotation ©2005 Book News, Inc., Portland, OR
Doody Review Services
Reviewer:Robert M Arensman, MD(University of Illinois at Chicago College of Medicine)
Description:This slim book contains the current information on anesthetic techniques used for mothers and fetuses undergoing prenatal interventions for definitive correction. As such, it summarizes much of the experimental work from the fetal surgery centers in San Francisco and Philadelphia, but goes on to elaborate on anesthetic interventions currently used for the few indications for fetal surgery. The book comes with a CD-ROM version.
Purpose:The two editors indicate their objective is quite simple: identification of "what we know for certain, what we believe to be true, and, most importantly, what we still need to learn." These are worthy objectives, but what we still need to learn to prevent preterm labor and fetal loss is so great that only very general and preliminary information is certain concerning the use of this technique and, therefore, the anesthesia that will be required. As an embryonic text, this book is quite nice, but it will require many editions over many years to approach its purpose.
Audience:The book is clearly written and can be read and understood by anyone from medical school onward. Unfortunately, its very narrow area of discussion limits its interest to a small group of obstetricians, pediatric surgeons, and anesthesiologists. The two editors are members of the fetal intervention group at Boston's Children's Hospital. They are very credible authors who have requested the assistance of 10 other writers from the United States and the United Kingdom.
Features:This reference opens with five general chapters on the fetus, mother, uterine physiology, monitoring, and preterm labor. These are all nice recapitulations of current knowledge and serve as good background information. The next five chapters deal with a specific diagnosis for which fetal intervention might occur (examples, myeloneningocele, pulmonary malformations, teratoma, twin-twin transfusion). Actual series of children treated are very small with high morbidity and mortality. However, they are indicative of the progress made to date and accurately summarize where the science finds itself today. The best part of this book is at the end -- the final two chapters on the EXIT procedure and EXIT to ECMO, both of which have applicability and reasonably common use currently.
Assessment:In summary, this book on anesthesia for fetal intervention is an early work that correctly emphasizes our need to recognize the problems of anesthesia for both mother and fetus when this evolving treatment modality is used. It nicely summarizes the small amount of knowledge we currently have in these fields and raises many questions about future direction for use and study.
Editorials
From The Critics
Reviewer: Robert M Arensman, MD(University of Illinois at Chicago College of Medicine)Description: This slim book contains the current information on anesthetic techniques used for mothers and fetuses undergoing prenatal interventions for definitive correction. As such, it summarizes much of the experimental work from the fetal surgery centers in San Francisco and Philadelphia, but goes on to elaborate on anesthetic interventions currently used for the few indications for fetal surgery. The book comes with a CD-ROM version.
Purpose: The two editors indicate their objective is quite simple: identification of "what we know for certain, what we believe to be true, and, most importantly, what we still need to learn." These are worthy objectives, but what we still need to learn to prevent preterm labor and fetal loss is so great that only very general and preliminary information is certain concerning the use of this technique and, therefore, the anesthesia that will be required. As an embryonic text, this book is quite nice, but it will require many editions over many years to approach its purpose.
Audience: The book is clearly written and can be read and understood by anyone from medical school onward. Unfortunately, its very narrow area of discussion limits its interest to a small group of obstetricians, pediatric surgeons, and anesthesiologists. The two editors are members of the fetal intervention group at Boston's Children's Hospital. They are very credible authors who have requested the assistance of 10 other writers from the United States and the United Kingdom.
Features: This reference opens with five general chapters on the fetus, mother, uterine physiology, monitoring, and preterm labor. These are all nice recapitulations of current knowledge and serve as good background information. The next five chapters deal with a specific diagnosis for which fetal intervention might occur (examples, myeloneningocele, pulmonary malformations, teratoma, twin-twin transfusion). Actual series of children treated are very small with high morbidity and mortality. However, they are indicative of the progress made to date and accurately summarize where the science finds itself today. The best part of this book is at the end — the final two chapters on the EXIT procedure and EXIT to ECMO, both of which have applicability and reasonably common use currently.
Assessment: In summary, this book on anesthesia for fetal intervention is an early work that correctly emphasizes our need to recognize the problems of anesthesia for both mother and fetus when this evolving treatment modality is used. It nicely summarizes the small amount of knowledge we currently have in these fields and raises many questions about future direction for use and study.
2 Stars from Doody