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Doody's Review ServiceReviewer: Gilad A. Gross, MD (Washington University School of Medicine)
Description: This is a book written for patients thinking about becoming pregnant or who are currently pregnant. The book hopes to attract the older population of women contemplating a family or currently pregnant.
Purpose: The purpose is to provide a review of pregnancy that is geared toward women who have delayed starting a family into their mid to late 30s/early 40s. This is a very timely objective given the fact that many women have delayed childbearing for numerous reasons. It is also timely in that recent changes in ACOG's recommendations regarding screening for genetic disorders have garnered lots of attention for the older gravid patient. The authors touch upon several issues that are relevant to this patient population, but could have gone into much more detail and provided more comprehensive data. Rather, they spend more time on the generalities of pregnancy that are pertinent to any pregnant woman, regardless of age.
Audience: This book is written for the patient or prospective patient. The authors have written several other books of a similar genre, independent reading for patients.
Features: In the end this book is basically a review of pregnancy. Some parts are geared toward the older patient, but the bulk is general pregnancy information that goes from preconception to pregnancy to the post partum. The book uses numerous anecdotes as a means to convey information. The authors recount their own patients' encounters (with falsified names) in an effort to bring the information to life, a relatively novel approach. Although I did not find these that helpful, they were mostly "feel good" stories that possibly could lend encouragement to patients looking for examples of others in similar situations. The appendixes and glossary are mainly basic general information related to pregnancy. The major shortcoming is the lost opportunity to truly provide detailed information about age-related pregnancy problems. These are skimmed over, and this lack of detail will lead the reader looking for age related information to search elsewhere for answers. A good example is the age-related risk of chromosome disorders, taking Down syndrome as the primary example. Although there is some good introductory information, there should be a whole chapter devoted to this topic. Much more information on these special pregnancies and children could have been provided. Support group information or a directory of information could be added. The nature of medical issues posed by a child with Down syndrome could have been added and many more issues could have been covered.
Assessment: Overall, this is relatively light reading for a patient thinking of becoming pregnant or already pregnant. Although the title indicates it is a book for patients over 35, it really does not offer much detailed information beyond what is relevant for any pregnant woman. Some may find the anecdotes useful in helping to bring the subject to life. Patients who are willing to read a 250+ page book would like more information pertinent to their situation. It also has to be said that at this time there is nothing magical about the age of 35. This is a relatively older notion and the newer thinking is not explained at all in this book.