Review of Consults in Obstetric Anesthesiology

This is a unique obstetric anesthesiology book that presents the topics covered in alphabetical order, making it easy to search or find a particular topic of interest. The author, who has worked for several years at a hospital with a busy obstetric unit, has written this book to share information on the management of the high-risk parturient, to guide management for patients with common problems such as obesity, to address acute disease states that may occur unexpectedly in the labor ward and during delivery, and to guide management of parturients with obscure diseases that may complicate pregnancy. The authors of this book are mainly from the United States and Canada. A quick look at the Table of Contents may make one conclude that this is a book full of obscure, rare, or uncommon diseases found in pregnancy; yet, the author covers many other common medical conditions such as asthma, human immunodeficiency virus, and obesity. Each author covers the different topics using a template with headings: definition, incidence, background information, presentation, symptoms, pathophysiology, pharmacology, effects of pregnancy on disease, effects of disease on pregnancy, and medical or anesthetic management. At the end of each topic, there are references for further reading. This makes this book useful to the anesthesiologist who really wants to understand the disease process related to pregnancy, especially one who is working in an obstetric unit and handles special or difficult cases. Other anesthesiologists may find it to be a good reference book as it covers a wide variety of medical conditions. The first topic or chapter is on abnormal placentation. The author gives the different types of abnormal placentation and quickly focuses on accrete by giving a good background on the disease and what is needed in preoperative consultation. There is mention of massive hemorrhage, which is found when managing obstetric hemorrhage and is a very common topic in obstetric anesthesiology. The following chapters are on achondroplasia, acromegaly, and acute fatty liver. Other topics related to liver disease in pregnancy are found elsewhere under such topics as cholestasis, cirrhosis, hepatitis, and hepatolenticular degeneration. The chapter on asthma is presented well including a good background and very practical management with the use of tables. The topic on cardiovascular risk assessment has tables which are easy to interpret without much explanation. Drug abuse is discussed in the chapters on use of stimulants and depressants such as amphetamines, benzodiazepams, caffeine, cannabis, cocaine, ethyl solvents, hallucinogens, illicit drug use, opioids, solvents, and tobacco. It would have been better to group these topics together under a heading such as drug and substance abuse in pregnancy. Others could have been grouped together in such areas as coagulation factor deficiencies and arrhythmias. There are other topics that are familiar in obstetric anesthesiology that could have been covered or given in much more detail such as maternal or neonatal resuscitation, epidural top up for a patient who was in labor and now requires cesarean delivery, perimortem cesarean delivery, anesthesia for the pregnant patient who requires nonobstetric surgery, eg, for acute appendicectomy in pregnancy, airway management/difficult intubation, use of uterotonics, fat embolism, and management of the pregnant patient with a tropical disease like malaria. Considering the size of the book and the number of topics that are covered, the index could have included more key terms allowing for an easier search of key issues. For example, in the index, postdural-puncture headache is found in the section on human immunodeficiency virus. I congratulate the author for coming up with an obstetric book including essentials of so many different medical conditions that focus on the pathophysiology and medical management. This is a book that finds its place in obstetric units and in the anesthesiology library. Considering the size of the book, I think some readers may settle for an eBook. Edson Chikumba, MMed AnaestheticsDepartment of Anaesthesia & Critical Care MedicineCollege of Health SciencesUniversity of ZimbabweAvondale, Harare, Zimbabwe[email protected]

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