Obstetric and Intrapartum Emergencies: A Practical Guide to Management Edited by EdwinChandraharan, SabaratnamArulkumaran. New York: Cambridge University Press, 2012; 282 pp; $69.95 (softcover).

Abstract

Obstetric and Intrapartum Emergencies: A Practical Guide to Management is a soft-covered book outlining the various emergencies that providers may encounter when working in an environment of pregnant patients. This book review came at a perfect time. At one of the places I currently work, there was a recent change in staffing where the emergency physicians are now responsible for care of the pregnant patients, regardless of their weeks of gestation. So after practicing for over 15 years without managing pregnant patients over 20 weeks, this dog had to relearn some old tricks and learn some new ones as well. I can tell you it can be quite frightening. So when I reviewed this book, I was looking at whether this guide would be able to assist me in both types of hospital settings. Would it be comprehensive enough in the limited-resource facility? The resources used to write this book came from contributors practicing in well-resourced and less-resourced centers in the United Kingdom and Sri Lanka. The book is divided into 40 brief, well-focused chapters, each being around six pages long. The topics are divided into nine sections, such as general principles, intra- and postpartum emergencies, medical and surgical emergencies in pregnant patients, imminent deliveries, and simulation training. Each chapter is divided into sections that include key actions, key pearls, key pitfalls, and what is crucial to do when in a “low-resource setting.” Some of the chapters have stimulation cases that walk one through step-by-step instructions on how to approach certain patient problems. The key actions review the important aspects of the case, as well as the simplest thing you might overlook, for example, not just calling an obstetrician for an imminent delivery, but also informing her or him in the case of a cord prolapse, so she or he can get the operating room ready. One of the positive aspects of this book is the inclusion of algorithms for the management of specific obstetric emergencies, such as preeclampsia/eclampsia, obstetric hemorrhage, septic shock, and seizure in pregnancy. These algorithms are clear and concise and can easily be referenced. Another positive aspect of this book is the common toxicologic ingestion table. It is a quick reference table listing potential common drugs ingested by the pregnant patient, along with the clinical effects and the actions that need to be taken. What kind of provider would find this book helpful? This book will be helpful to providers who infrequently encounter the second- and third-trimester pregnant patient, whether it be the emergency physician, family practitioner, midwife, or nurse. It is a concise overview of the complications one might encounter treating the pregnant patient. It is a starting point for treating and stabilizing the patient, until the appropriate provider—the obstetrician—can take over. However, if you are looking for a detailed protocol of breech delivery or a shoulder dystocia, this is not the book for you.