Book Review

Fetal Medicine: Basic Science and Clinical Practice

N Engl J Med 2001; 344:779-780March 8, 2001

Article

Fetal Medicine: Basic Science and Clinical Practice
Edited by Charles H. Rodeck and Martin J. Whittle. 1162 pp., illustrated. Philadelphia, Churchill Livingstone, 2000. $130. ISBN: 0-443-05357-X

Fetal Medicine: Basic Science and Clinical Practice is a pioneering textbook that captures the remarkable revolution in the field of fetal medicine. Written by authors from around the world, it combines basic knowledge and practical application and will be useful to anyone interested in obstetrics, neonatology, prenatal diagnosis, and perinatology.

The book includes sections on cell, molecular, and reproductive biology; the physiology of the fetus and placenta; ethical issues; epidemiology, including a discussion of the consequences of fetal disease in adulthood; prenatal screening and diagnosis; fetal genetic disorders; diagnosis and management of malformations and fetal illness; and techniques for monitoring the fetus and neonate. Maternal illness is mentioned only briefly, since there are many other textbooks on maternal health and obstetrical care.

The editors have allowed the authors to approach their subject as they see fit, and so there is occasional overlap. The list of writers is truly outstanding. The section editors are leaders in the field, and the result is a remarkable combination of information and expertise.

Color illustrations are grouped at the front of the 1162-page book, but black-and-white illustrations are liberally sprinkled throughout. The quality of photographs and charts is excellent, and the long list of references makes it easy to refer to original textbooks. Each section is focused and outlines the material succinctly. Basic information such as the genes involved in embryonic and fetal development and normal values are readily found by means of the index and through the logical organization of the book. The topics covered are obviously complex, and there is little doubt that such a valuable book will need to be updated regularly.

The book makes it clear that many new developments are on the horizon. Among topics to be explored are evidence-based clinical guidelines for fetal medicine, legal aspects of maternal–fetal medicine, immunization of the fetus with maternal proteins, and the interesting question of whether retained maternal cells cause disease in the fetus or during adulthood. There will also be an increasing number of problems caused by drugs and alternative medicine. The evaluation of fetal movement has just begun, norms are just being established, and the essential nature of fetal movement with respect to normal development is beginning to be appreciated.

Fetal Medicine is a must for anybody working in the field. It is particularly appropriate for fellows and residents in maternal–fetal medicine and neonatology as a general reference that provides an overview of a very complex field. This is a welcome book at a critical time in the development of the field. The editors suggest that it took 10 years of enormous effort to pull it together. That effort was certainly worth it.

Judith Hall, M.D.
University of British Columbia, Vancouver, BC V6H 3V4, Canada