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Doody's Review ServiceReviewer: Anthony Shanks, MD (Washington University School of Medicine)
Description: This is an evidence-based resource that attacks the significant health problem of preterm birth from multiple angles.
Purpose: The purpose is to investigate the epidemiology of preterm birth and discuss the pathophysiology and interventions that attempt to decrease it.
Audience: The book is aimed at physicians and physicians in training in the field of obstetrics. All physicians would find it interesting, but those who work in high-risk obstetrics may find it most helpful. The authors are some of the most respected names in the field of maternal-fetal medicine.
Features: The economic and medical burden of preterm birth is supported by statistics in the introductory chapter on the global impact of preterm birth. Given the multifactorial nature of preterm birth, subsequent chapters break down each problem individually. Genetics of preterm birth, the cervix, and inflammation are just some of the areas that the book chooses to tackle. The excellent chapter on the genetics of preterm birth has an interesting spin on the genetic associations of preterm birth and, thankfully, the author stops short of recommending routine genetic testing. Chapter 6, on the cervix, and chapter 12, on short cervical length, are two very important chapters on conditions that are the source of many referrals to maternal-fetal medicine specialists. Chapter 6 presents the physiology of cervical disorders and its association with preterm birth while chapter 12 takes the clinical perspective, discussing what to do with this information. Certainly these two chapters could have been presented next to each other, but that is a small quibble. Chapter 20 is a nice treatment of fetal lung maturation. Given that antenatal steroids have been proven to improve neonatal morbidity and mortality, it is essential to have an adequate discussion of this in a book on preterm birth. This chapter is very thorough, although the author comes down on the side of not providing rescue steroids. That is certainly an acceptable management strategy, but the language in the Committee Opinion from ACOG (February 2011) seems to advocate the other side.
Assessment: This is an excellent reference that covers the pathophysiology and potential interventions for this global health problem. The credibility of the authors lends added weight to the book.