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Doody's Review ServiceReviewer: Bernard Wittels, MD, PhD (University of Chicago Pritzker School of Medicine)
Description: The authors are a pair of British anesthetists who have compiled a text on obstetric anesthesia that is organized and presented with a unique style and consistency. Perhaps a more accurate title would be "A British Perspective of Obstetric Anesthesia." In this text, the authors put forth rather narrow, personal perspectives with regard to content and organization, omitting efforts to be thorough, exhaustive, or authoritative.
Purpose: The authors give credit to the late Dr. Jeffrey Selwyn Crawford as the original author and strive to maintain a "traditional individual textual style, rather than a multi-author, edited tome."
Audience: According to the authors, this text is intended for those taking professional exams and for anyone "with a profound interest in obstetric anesthesia." Because they direct much attention to specific British methods for obstetric service organization, monitoring, and auditing, their text seems most appropriate for anesthesia residents and practitioners working specifically within such British systems.
Features: After describing the organization of British obstetric anesthesia services, the authors organize content by medical system, discussing normal physiological changes of pregnancy together with disease conditions within the same system during pregnancy. Regional and general anesthesia techniques are briefly reviewed, along with maternal and fetal conditions that pose high risks. There are numerous tables and lists of information, with a few black-and-white diagrams; color content is absent. This kind of organization is rather unusual. Often, the authors note what is self-evident, for example, that a thorough history and physical exam is important. Many tables and lists contain items not distinguished by either importance or severity. Discussions are often limited and incomplete, with recommendations that are clearly opinionated and based on literature from past decades.
Assessment: The authors present an abbreviated, personalized overview of their British practice of obstetric anesthesia. The organization and depth of information presented appears to reflect personal preferences without rigorous attention to completeness, accuracy, or the latest updates in the literature. This writing style is unique, but lacks significant academic value. In contrast, multi-authored texts with editorial overview are much more logically organized, thorough, complete, and accurate, and include the most recent articles in the literature such as Chestnut's Obstetric Anesthesia: Principles and Practice, 2nd Edition, (Mosby, 1999).