Obstetrics and Gynaecology

From The Critics

Reviewer: Tammy Lee Shim, MD(Washington University School of Medicine)
Description: This compact book is a helpful and cursory overview of the most common obstetrical and gynecologic problems. It is designed as a pocketbook for easy and quick reference to the most common chief complaints seen in the field. In this kind of reference, the index is key to quickly guide one through the text. The division of information by chief complaint demands a fairly comprehensive overview of the differential diagnosis, which this book does provide.
Purpose: The author's purpose is to provide an immediate reference resource for medical students and health professionals dealing with obstetric/gynecologic issues. There does appear to be a lack of quick reference resources for obstetric/gynecologic emergency situations. The author, overall, does meet his goal of providing a useful book for these situations. However, there are obvious gaps in information and the author does acknowledge this fact in his preface stating this is not a comprehensive resource, but "adequate for the common problems."
Audience: "The author intends the book for medical students and all physicians in obstetrics and gynecology or emergency medicine. It is most suitable for students, midwives, nurse practitioners, emergency medicine physicians, and obstetrics and gynecology residents. More than 30 contributing authors from the U.K. have assisted in the compilation of this book. "
Features: "Although this guide covers a great deal of the most common obstetric/gynecologic emergencies, there are areas of deficiency, including a lack of discussion on preeclampsia or HELLP and a lack of information on specific topics. For example, the section on ectopic pregnancies does not include a discussion about beta-hCG levels and correlation to diagnosis by transabdominal or transvaginal ultrasound. A separate section on methotrexate dosing and contraindications to its use is inconveniently placed in another chapter. On the other hand, it is useful to have a guide structured by chief complaints. For example, abdominal pain in pregnancy will include an extensive list of the differential diagnoses and what further workup is needed. For this reason, this book is useful in helping to think thoroughly through an appropriate differential when the diagnosis is not immediately known. The section on neonatal resuscitation is an added practical benefit. On initial glance at the table of contents, the division of material between the obstetric complications and medical emergencies in pregnancy was not clear. The author chose to separate the material into gynecological organ-related issues versus all other organ-related problems in a pregnant woman. Also, postpartum fever is not listed under post-delivery procedures and complications, but instead is classified under miscellaneous topics in obstetrics. The organization could be better; however, the index does make up for this. "
Assessment: This is a helpful resource in a field where there is a clear lack of resources specifically dealing with this topic. Before purchasing this book, however, it is important that readers realize the author and contributors are all from the U.K. and thus there is some variance in the types of medication treatments. For example, the Lord Fraser Guidelines for contraception competence of a teen may not be relevant outside the U.K. Acronyms are also very different but there is a key to those acronyms at the beginning of the book. Overall, this type of quick reference guide is practical and useful for healthcare professionals dealing with obstetrics and gynecology patients.