Book Review

Ultrasound in Obstetrics and Gynecology

N Engl J Med 1993; 329:514August 12, 1993

Article

Ultrasound in Obstetrics and Gynecology
Edited by Frank A. Chervenak, Glenn C. Isaacson, and Stuart Campbell. 1801 pp. in two volumes, illustrated. Boston, Little, Brown, 1993. $199. ISBN: 0-316-13865-7

This two-volume textbook provides a comprehensive, up-to-date review of obstetrics and gynecology and of the role of ultrasound in this field. The title is something of a misnomer, since many of the topics covered are unrelated to ultrasound. These include fetal assessment and evaluation by means other than ultrasonography and an extensive discussion of obstetrical and gynecologic management. Unfortunately, the chief weakness of the book is the quality of the ultrasonographic images. Many of the images are outdated, produced by older real-time scanners or even by static scanners. Inexplicably, numerous fairly common entities are illustrated by static images. Furthermore, some of the images have far too much contrast, with poor resolution. The editors of a textbook on ultrasound should have devoted more attention to the quality of the images.

The book is divided into five sections, with more than 20 chapters in each section. The first, entitled “Background,” provides a review of the physics and machinery for ultrasound and Doppler techniques. The chapters describing current machinery and Doppler ultrasonography are excellent. This section also includes useful information about the integration of ultrasound systems into a clinical setting, with discussion of image recording and computerization of data. Its main drawback is the lengthy description of older equipment no longer in use, such as static scanners. Section 2, “Fetal Assessment,” is comprehensive and well written. It includes, however, many chapters on topics unrelated to ultrasound and numerous sonograms that are of poor quality or outdated.

Section 3, “Fetal Anomalies,” is generally well written and has excellent pathological correlations and pathological images. The sonograms, for the most part, are of good quality, but even in this section some scans have poor resolution, were obtained with static scanners, or have too much contrast. This section also suffers from uneven editing, which has allowed a number of misstatements to slip through. In chapter 91 on multiple gestations, for example, the authors incorrectly equate acardiac twinning with the twin-twin transfusion syndrome and describe the twin reversed arterial perfusion (TRAP) syndrome as a separate entity. In fact, acardia and the TRAP syndrome are synonymous and are distinct from the twin-twin transfusion syndrome. This chapter includes a categorization of conjoined twins as “completely” as opposed to “incompletely” duplicated, a categorization that is confusing at best.

Section 4, “Interventional Procedures,” is complete and well written, describing indications, methods, and results. Section 5, “Clinical Obstetrics and Gynecology,” is a comprehensive discussion of obstetrical complications, diagnosis, and management. Several chapters in this section contain poor-quality ultrasound images.

Overall, this book is a comprehensive review of diagnosis and assessment in obstetrics and gynecology and, as such, would be a useful addition to the libraries of practitioners in these disciplines. It is far less useful, however, as a reference on sonography, since other textbooks are available with far better, state-of-the-art images.

Carol B. Benson, M.D.
Brigham and Women's Hospital, Boston, MA 02115