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Doody's Review ServiceReviewer: Tariq M. Malik, MD (University of Chicago Pritzker School of Medicine)
Description: This is a review of the implications for anesthesiologists who may have to provide labor epidural for pain control and delivery to women with uncommon diseases. Each disease is discussed, keeping in mind that the patient may request an epidural for pain relief or may have to have a cesarean section. The format ensures that there are guidelines for these two eventualities under each disease, making it a very handy resource in the middle of the night. This edition has two more chapters than the previous edition published in 1997.
Purpose: This is intended as a quick resource for anesthesiologists when they are faced with a patient with some rare disease who needs an epidural for labor and delivery or a C-section. This situation is bound to happen eventually to everyone. The book fully serves this purpose with its practical and succinct description of each disorder along with anesthetic management guidelines.
Audience: Although anesthesiologists who practice obstetric anesthesia are the main audience, obstetricians may find this book helpful as it provides insight into how a labor epidural can potentially improve their patients' outcomes. The authors have vast clinical experience.
Features: Five sections cover diseases affecting the cardiovascular and pulmonary systems, the musculoskeletal system, the nervous system and metabolic disorders, malignancies, rheumatologic disorders, and infectious diseases. Every chapter uses the same format covering the incidence, pathophysiology, clinical features, and medical management of the disease. The review ends with a discussion of principles of anesthetic management of the patient with special emphasis on providing labor epidural pain relief or a spinal for a C-section. The format is attractive, the text easy to read, and the guidelines are clear and practical. The book makes no attempt to provide a detailed discussion of the diseases, nor is it intended to do so. The focus is on discussing the principles of anesthetic management after providing brief insights into the pathophysiology of the particular disorder. This helps anesthesiologists to formulate and execute a rational plan based on a patient's altered physiology.
Assessment: Anesthetic and Obstetric Management of High-Risk Pregnancy, 3rd edition, by Datta (Springer, 2004), is the only other book that provides comparable information, but that one has a different scope. Even though the information in this book is readily available online, as conceded by the editors in the preface, I agree that there is no alternative to a well written book like this one. I strongly recommend that it should be available to anyone covering obstetric anesthesia, whether a resident in training or a consultant anesthesiologist.