Evans. Hugh, M. D., and Glass, Leonard, M. D. PERINATAL MEDICINE Hagerstown, Md.: Harper & Row, Publishers, 1976. 604 pp., $38.50
The authors note in their preface that the field of perinatal medicine has grown during the past decade. Evidences of this growth can be seen all around us - in the reduction in both maternal and infant mortality during recent years; in the progress that has been made in the care of, and diagnostic procedures for, the pregnant woman and the newborn infant; in the increasing numbers of physicians and nurses who are specializing in perinatal medicine; in dual physician and nursing appointments to the departments of obstetrics and pediatrics at major medical centers; in the vast increase in perinatal publications; and in the formation of both regional and national perinatology societies.
This volume has to be commended, for it brings basic science and the practice of neonatal medicine together. Unlike some other texts (which also are very valuable), it avoids specific case presentations; inclusion of these would only make the volume longer without adding many facts. The authors also must be complimented for including numerous illustrations and references, and for not avoiding controversial subjects such as fetal research and abortion.
Most of the chapters were written by Dr. Evans and Dr. Glass. These include basic information on many of the most important problems the pediatrician faces in the care of the newborn and, in particular, in the care of the premature infant. Of special value are the excellent chapters on intensive care, hyperbilirubinemia, respiratory distress syndrome, and bacterial and nonbacterial infections. It is evident that the authors have had vast personal experience in the problems of the normal and the sick infant.
A few sections of this valuable text were written by the authors with the aid of specialists in various fields. Among these are chapters on the high-risk pregnancy and fetal monitoring, ultrasound, and neonatal cardiology (including catheterization, echocardiography, and cardiac surgery).
The chapter on pharmacology written by Dr. Sanford N. Cohen and Saraswathy K. Ganapathy will be of special importance to all pediatricians. We know now that nearly all drugs given pregnant women can cross the placenta and affect the fetus. Who would have known 20 years ago that diethylstilbestrol given frequently during pregnancy could be the cause, years later, of adenocarcinoma of the vagina in the adolescent daughter? One of the valuable parts of this chapter is a table of commonly used drugs, indicating the correct dosage for the newborn.
Dr. S. Frank Redo has written one of the finest chapters in the book, on surgical problems. He stresses that only lifethreatening crises should be treated - that elective procedures should be avoided. As Dr. Redo says, "it is better to proceed stepwise and ultimately achieve a viable infant than to attempt a simple definitive procedure with a fatal outcome." Dr. Redo discusses lesions involving all parts of the neonate systematically and in considerable detail. The sections on neurosurgical problems (head trauma, hydrocephalus, etc.) have been written in collaboration with Dr. Joseph H. Galicich, a neurosurgeon.
Special problems of neonatal radiology are discussed by Dr. Walter E. Berdon, who includes many valuable x-rays.
One of the most important and practical chapters is the last one, on medicolegal aspects, written by Dr. Daniel J. Tennenhouse. There are many legal hazards for the team caring for the pregnant mother and the newborn, particularly today, when patients frequently sue and malpractice insurance has become very expensive. The author concludes that a "lawsuit should be viewed neither as a personal attack on the integrity of the physician nor as evidence of incompetent medical practice."
An appendix is included that lists many recent findings, such as nasojejunal feedings.
The authors might have expanded the obstetrical aspects of this field with the help of additional contributors. One realizes, however, how difficult this is, and therefore this is merely a suggestion and not a criticism of this fine volume. It is a book that should be in the library of every physician dealing with the newborn infant.