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Doody's Review ServiceReviewer: Gilad A. Gross, MD (Washington University School of Medicine)
Description: This is a synopsis of evidence from randomized controlled trials (RCTs) and Cochrane Reviews related to the care of women and infants before, during, and after pregnancy. The abstracts in the book are from the Cochrane Pregnancy and Childbirth Group, as well as numerous other specific Cochrane Review Groups, such as those on anesthesia, depression/anxiety, infectious disease, and others.
Purpose: The purpose is to make evidence readily available in a user-friendly format to caregivers and policy makers. In this, the handbook presentation proves quite helpful. The ability to make evidence-based randomized controlled trials (RCT) easily accessible can be translated into helping clinical and policy/protocol decision making. This is necessary to help bridge the gap between researchers who generate evidence and practitioners who interpret and implement the data. The book does a good job.
Audience: According to the author, the audience for the book includes "public/private decision makers" and "health workers responsible for the care of childbearing women." In actuality, the audience could be much broader, including medical/midwifery students, obstetrics/gynecology physicians in training and current practice, family practitioners providing obstetric care, maternal-fetal medicine specialists, as well as hospital and nursing administration/leadership. Clinical researchers also can use this as a resource. The book largely meets the needs of the intended audience.
Features: The book is a summary of RCTs and Cochrane Reviews with links to the Cochrane Library, covering topics that the Cochrane Reviews have attempted to study. It simply presents a synopsis of a review; it does not delve into the details of the studies, such as disease or condition etiology, pathophysiology, diagnosis, etc. All reviews are included, including those with definitive conclusions as well as those where reviews are still in progress (referred to as "systematic review protocols"). Studies with clear-cut evidence of either benefit or harm are noted by effectiveness icons. Overall, the presentation is clear and each entry is cross-referenced to the Cochrane Library via a CD number (relying on the reader having access to the Cochrane Library). It bears mentioning that evidence is limited to RCTs only, which some readers may consider a shortcoming. Additionally, because there is limited evidence in many areas of obstetrics (and partly due to the restriction of evidence to RCTs), several topics are not covered. However, this could help set priorities for research.
Assessment: This is a valuable summary of available evidence from RCTs for pregnancy and delivery care. The value of the book lies in its brevity and user-friendly format. However, since it is limited to RCTs, it fails to capture the entire body of evidence available to inform practice. Partly as a consequence of this and partly because it is characteristic of the field, there are evidence gaps in several areas of pregnancy and delivery care. However, as a portal of entry to the valuable Cochrane Database, this handbook is a unique and highly effective contribution to the field of evidence-based obstetrical care.