Anesthesia and Obstetric Management of High Risk Pregnancy, Second Edition. By Sanjay Datta. St. Louis, Mosby Year Book Inc., 1996. Pages: 637. Price:$95.00
In the face of the seeming plethora of obstetric anesthesia texts currently available, it would seem difficult to find a niche for a new text. Dr. Datta has succeeded. Although at first glance Anesthesia and Obstetric Management of the High Risk Pregnancy would seem to be nearly another variation on theme, the editor's approach was refreshingly new.
As with many of the new textbooks that are currently available, this text is multiauthored with the inherent hazard of diverse backgrounds with the potential of producing uneven presentations and differing philosophies. For the most part, this did not happen. The style, contents, and presentations are remarkably consistent throughout the text, and the chapters are imminently readable.
Considering that each chapter was dually authored by an obstetric anesthesiologist and a second author representing a different specialty (usually obstetric), this outcome is even more remarkable. I found the dual specialty approach particularly valuable because the final product obviously represents obstetric and anesthetic view points. Obstetricians hoping to gain insight into obstetric anesthesia would find this text a valuable resource and perhaps more credible because of the obstetric input.
The scope of covered topics is relatively complete and in some regards innovative. Absent are the traditional chapters regarding physiology of pregnancy, pain pathways, uterine blood flow, and chapters dedicated to pharmacology. In their stead are topics that are not normally included in most texts. For example, sections on obstetric care of the patient with psychiatric disease, erythroblastosis fetalis, and anesthesia for intrauterine fetal manipulation were beneficial inclusions not frequently found in traditional texts.
Because the chapters regarding physiology are not included in the text, each chapter contains pertinent background information related to the chapter topic that provides enough information for decision making. In some instances, for those who are looking for a quick resource, background information may be deleted from the reading without detrimental effects. For example, the Endocrine chapter contains an excellent introductory portion regarding hormones and target organs. However, this information may be of little value for those whose purpose for reading the chapter is the direct application of information to patient care. Therefore, this portion of the chapter may easily be passed over, and the reader may immediately proceed to obstetric and anesthetic management for the particular endocrine problem.
I also appreciated the editors' and authors' willingness to make specific recommendations regarding anesthetic management. No longer does a reader have to ferret through potential obstetric managements, the pros and cons of anesthetic managements, and then select an appropriate management plan. For those practitioners seeking a quick source, a plan is readily available. Finally, the text is the most comprehensively illustrated text I have read. Further, the illustrations and tables contain more than information. Rather, they frequently address decision-making. The chapter addressing fetal distress was complete with valuable and practical advice in tabular form. The tables presented in the Antepartum Hemorrhage and Hepatic Disorders section were also informative and practical. Other chapters I particularly appreciated dealt with The Febrile Patient and Intrauterine Fetal Death, and the chapter addressing diabetes was a superb problem-based chapter.
In summary, I believe this textbook is a valuable resource for those who practice obstetric anesthesia, whether they are the occasional providers of care seeking anesthetic plans or those practicing in a specialized obstetric unit who requires quick access to additional information for unusual problems. Dr. Datta-well done!
David M. Dewan, M.D.
Professor of Anesthesia; Head of Section; Obstetric and Gynecologic Anesthesia; Bowman Gray School of Medicine; Wake Forest University; Medical Center Boulevard; Winston-Salem, North Carolina 27157–1009
