Anesthesia and the Fetus Editors Yehuda Ginosar, Felicity Reynolds, Stephen Halpern, Carl P Weiner Wiley-Blackwell, 2013 ISBN: 978-1444337075, Hardback, 418 pages, £94.99



Most anaesthetic textbooks concentrate on the impact of anaesthesia on the mother with little detail on the effects of analgesia and anaesthesia on the fetus. Textbooks in obstetrics, perinatology, neonatology and midwifery often give little detailed consideration of the effect of anaesthetic interventions on the fetus and newborn. I believe that this book has successfully integrated into one textbook the impact of anaesthesia on the fetus and newborn as well as detailed information on fetal pharmacology, physiology, development and monitoring.

This book is well constructed and written by an international group of well renowned clinicians and scientists from USA, Canada, Israel, UK, Australia and New Zealand. One disadvantage of such an international authorship is a lack of focus on specific UK drugs and practice including specific resuscitation guidance, but it is interesting to look at the interpretation of the evidence that defines international practice and aspects such as the law as it affects the fetus in different countries.

The book is well laid out in a traditional format and is easy to read. Each section covers basic knowledge but also looks in depth at the available evidence and recent advances.

The first section covers in appropriate depth fetal physiology, pharmacology and the changes at birth. The second section covers detail on antenatal and intrapartum fetal assessment methods – possibly the chapter on validity of endpoint measurement may be a little detailed for some. The third section is a major focus of the book and looks at the effects of anaesthesia, drugs and analgesia on the fetus including considerations for non obstetric surgery and assisted reproduction techniques. This section is particularly detailed and looks in depth at the evidence behind the choices and modifications in conduct of anaesthesia for caesarean section and analgesia for labour from the fetal perspective. The fourth section, entitled The Compromised Fetus, covers details of multiple pregnancies, pre-eclampsia and fetal distress. The fifth section looks primarily at resuscitation guidance including perimortem delivery, the management of trauma and the principles and practice of intrauterine fetal resuscitation. The final section touches on ethical decision-making and the law as applied to the fetus.

This book is hardback with good quality printing and easy to read layout. The illustrations are mainly in black and white with just a few in colour – unfortunately some are not particularly well reproduced.

Unusually for a medical textbook, I believe this book will have true multidisciplinary appeal. It will be of interest to specialist obstetric anaesthetists, obstetricians – particularly those with a fetal medicine interest – neonatologists and specialist midwives. As such, I believe it has found a unique place in the current market.

The only negative aspect is the relatively high price – although not unreasonable for such a well constructed hardback book, this will likely reduce demand on an individual basis. Clearly this book will be ideal for reference in departmental and hospital libraries and I will be recommending this to ours.