American College of Obstetricians and Gynecologist

Treatment guidelines are usually dreary to read at best, with too much time wasted on fluff, level of evidence data, and without being straightforward and concise. When you are in a huge rush to locate a specific piece of information, I usually grumble reading these kinds of medical texts because they force you to read 50 pages of filler, time that could be better used reading something else.

This book is not perfect by any means, but for a guideline manual, it's surely one of the better ones show more I have read. And indeed, it does reveal some facts that go against previously heralded medical dogma.

Proteinuria is no longer an obligatory diagnosis criteria of preeclampsia? Whoa! We all went to med school assuming Edema and Proteinuria are obligatory hallmarks for this diagnosis. This manual states that Proteinuria is a lesser diagnostic criteria; important indeed, but many cases of preeclampsia can be made with only slight proteinuria. Furthermore, by itself, proteinuria is not a major risk factor to develop this disease later on during pregnancy.

I already knew about low dosage aspirin for high risk cases in which high resistance umbilical cord artery pressures by Doppler can reduce the risk of developing preeclampsia, but this manual downgrades its usefulness in which doppler ultrasound is still highly unreliable due to various causes, among them, the need for mastery of measuring placental flows by expert hands.

To treat o not to treat? That is indeed a commonplace conundrum for GP physicians with patients with risk factors for developing preeclampsia and presenting with slight hypertension. The updated guidelines stipulate that you have to view risk/benefit from aggressive antihypertensive therapy. Reduce blood pressure at the expense of affecting the fetus and mother from slightly diminished oxygenation? Which drugs are the safest bets? The manual comes in handy here.

Ecclampsia no longer demands seizures to be present; any patient with diagnostic criteria for preeclampsia with any sort of neurological symptom can have this diagnosis. Increased weight is offered towards creatinine levels increased twofold or above 1.2 mg/dl.

Now, for all of the good things about the manual, there is filler. The same drug dosage reccomendations and some of the associated tests will be repeated ad nauseum. If you already know that data, just skip those parts.

All in all, the text reads pretty well and steps were taken to keep the chapters somewhat organized. While not a perfect book, it comes in handy not just for OB/GYNs and Anesthesiologists, even GP doctors can benefit reading this book.

I award the book 3 1/2 stars. show less

Far from a neutral source. But I was curious what I would think after having given birth. And it was free from my husband's insurance. And not quite accurate, or maybe forthright is a better word? ... but a good base. Still a little supercilious in tone.