Most practicing physician anesthesiologists in community hospitals and teaching hospitals are obliged to cover obstetrical anesthesia during the work day and call coverage, which may be the most stressful part of a practice. Keeping up with the literature specific to obstetric anesthesia may be a challenge to the busy practitioner. The revised and updated 5th edition of Shnider and Levinson’s Anesthesia for Obstetrics will significantly help with this.
It has been 11 yr since the 4th edition of Shnider and Levinson’s Anesthesia for Obstetrics was released. There have been advances in the field of obstetric anesthesiology since then, focusing on neonatal resuscitation and management of neonatal neurologic injury. The editors in the new edition were eager to improve the content by providing the most up-to-date information, while preserving the original quality of the text as they did in the 4th edition.
The updated edition is divided into 11 parts. The first section reviews physiology and pharmacology. The initial topic focuses on the areas of uteroplacental circulation, physiological changes of pregnancy, and placental transfer of drugs. The second, third, and fourth parts cover assessment of fetus, labor analgesia, and anesthesia for cesarean delivery. This goes in depth looking at intrapartum fetal monitoring as well as regional anesthesia techniques. The fifth, sixth, and seventh portions cover neonatal concepts of wellbeing, anesthetic considerations for obstetric complications, and management of anesthetic complications. There is in depth look at abnormal fetal positions, obstetric hemorrhage, NPO controversies, and postdural puncture headaches management.
The latter sections cover anesthetic management of parturients, ethical challenges, maternal morbidity and mortality. Very difficult topics we face are covered, including the Jehovah’s Witness patient, trauma resuscitation, and the global perspective of obstetric anesthesia. Some detail is provided for in vitro fertilization and nonobstetric surgery during pregnancy. Fortunately, given its emergence and growing popularity, the newer, ex utero intrapartum therapy surgical procedure is discussed.
The appendix has updated guidelines for neuraxial anesthesia and practice guidelines for obstetric anesthesia along with intrapartum fetal heart rate monitoring.
Shnider and Levinson’s chapters are well organized, contain excellent depth, and are informative. The online access offers a full version site with full images to view.
What sets this text apart is the detail in each of its chapters. For those of us who cover obstetric anesthesiology regularly while on call, a review of it is a must. This is an excellent resource for the clinician in training, such as residency or fellowship, or in practice. The chapters are detailed, with complete images, and online access make this a must own reference. The only area for future improvement would be adding ultrasound-guided neuraxial techniques, given the trend in anesthesiology.
I strongly recommend this book as a priceless addition to the library of any well-rounded anesthesiologist who covers obstetrics full time or part time.