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Doody's Review ServiceReviewer: Anthony Shanks, MD (Washington University School of Medicine)
Description: This fourth edition of a book dedicated to the interpretation and management of fetal heart rate tracings incorporates new terminology agreed upon at the last consensus conference.
Purpose: The book describes the physiology, indications, and management for fetal heart rate tracings. Both intrapartum and antepartum conditions are evaluated. The book succeeds at becoming the definitive textbook for antepartum surveillance.
Audience: Residents and physicians in obstetrics/gynecology are the intended audience.
Features: The book is divided into a brief history, physiology, diagnosis, and management of fetal heart rate tracings. I particularly enjoyed the history of fetal monitoring. As today's trainees enter the workforce with such a ubiquitous monitoring system, it is important to reflect on what led us to this point. The physiology section is well presented, but the images could be updated. Figures and illustrations are medically correct but appear old (figure 2.1 is an image from a 1969 publication). Incorporation of the new terminology is also well done. Chapter 3 discusses the complex subject of hypoxia and neonatal encephalopathy with good definitions and figures. However, a figure outlining the risk of stillbirth in various conditions (e.g. chronic hypertension) would have been helpful. This information may have been more suitable in another chapter, but I never came across it. Chapter 8, on clinical management of abnormal fetal heart rate patterns, is solid and the sample tracings give readers sufficient exposure to practice their interpretations. Some of the suggested maneuvers may come across as overly simple, but should still be explained for the purposes of this book.
Assessment: This is a welcome update of this book on the interpretation and management of fetal tracing. The revision was necessary given the significant changes in terminology. It would have been great if more new data had emerged about the management of tracings, but that is not a limitation of the book as much as a limitation of the science around improvements.