6^th edition Published 2020

By Catherine Nelson-Piercy

Published by CRC Press

ISBN  978-0-367-34612-6

Price £66.99 (Paperback)

https://www.routledge.com/Handbook-of-Obstetric-Medicine/Nelson-Piercy/p/book/9780367346126

Women who are pregnant or who want to be pregnant may present to a substantial number of diverse specialties and sometimes their medical state can cause specific clinical problems. If a patient tells us they are pregnant and we are about to embark on a therapeutic intervention then there is always a pause for thought (and so there should be!). Any intervention in a pregnant (or potentially pregnant) patient should be assessed in terms of benefits and risks and within that risk, there should be assessment of potential harm (as well as gains) both to the mother and foetus. So a degree of solid background knowledge is essential to make an informed decision.

This is where this excellent book comes into its own. Now in a sixth edition with a single British based author (a Professor of Obstetric Medicine based in London) this book is a substantial reservoir of practical knowledge, ideal for helping you deal with a patient problem. It is not a huge book and I reviewed the paperback version which contains 362 pages. However, it is packed with highly relevant clinical information written in short, sharp bullet points which makes sourcing and intaking of the required information relatively easy. There are also text boxes titled with “points to remember” which are very helpful and provide neat summaries.

There are 2 sections to the book; the first section is a system orientated approach which is a logical and user friendly method of drilling down to the information you need. Relevant physiological changes are also covered and then onto the important clinical information which helps to guide patient management. The second smaller section is a list of tables, covering potential diagnoses of clinical problems presenting in pregnancy. Again, this is very useful and provides practical support.

Despite the fact that title contains the word “handbook” and runs to 362 pages, this book seems pretty comprehensive and will make an excellent reference source for its subject matter. Not surprisingly, there is an excellent section on hyperemesis gravidarum (page 237) and it is well written, clear and concise but provides a lot of valuable and relevant information. The pharmacological treatment section is particularly helpful and provides an excellent basis to help a clinician manage this problem.

I was also interested in the advice for pregnant women who want to travel to high risk areas where malaria is prevalent. The answer is on page 301 which is to encourage them not to go to these malaria prevalent areas. If however they still want to travel to such regions despite medical advice, then a suggestion is provided on what is the most reasonable prophylaxis to suggest in these circumstances. This example highlights the fact this book is designed for frontline clinical care and prepared to offer alternatives in potential tricky situations.

This book is full of wisdom and advice and I am sure will be much sought after. However it is not cheap and it does not come with a digital offering bundled with the purchase price.  Despite that, this is a high-quality book that easily satisfies a specific demand and I would hope to see this book widely used in obstetric and ante natal departments as well as in primary care.

Dr Harry Brown

January 2021