Clinical Protocols in Labour

Clinical Protocols in Labour

Book reviews Clinical Protocols in Labour M.S. Marsh, J.M. Rennie, P.A. Groves, CRC Press, Parthenon (www.CRCPress.com), Paperback, 212 pp., £33.99 (...

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Book reviews

Clinical Protocols in Labour M.S. Marsh, J.M. Rennie, P.A. Groves, CRC Press, Parthenon (www.CRCPress.com), Paperback, 212 pp., £33.99 (US$ 59.95), ISBN: 1 842 14085 X The authors describe Clinical Protocols in Labour as a ‘useful guide to practice for midwives and doctors working on the labour ward’. Essentially it is a publication of the guidelines used at King’s College Hospital, London for practice on the delivery suite. The text is compact and can be easily read in a few hours (time well spent on a quiet shift!). Although many of the principles are applicable to practice in other institutions, the specifics relate to practice within King’s College Hospital. I fear its appeal as a textbook is limited by this fact. Guidelines for practice are necessarily individualised to suit each Trust. Those seeking to update their guidelines will find this book useful forguidance.However,themainreadership forthisbook is the staff working on the delivery suite at King’s College. The book’s appeal to a wider audience is further restricted by a failure to document supporting evidence for the guidelines. Not all chapters are referenced. Those that are not are supported by a bibliography that includes three or four reputable postgraduate medical texts. Some guidelines will inevitably date quicker than others. In this format, new editions will be required on a frequent basis. The first half of the book is principally concerned with midwifery practice. It is thus surprising that none of the authors are midwives, although acknowledgment is given to named midwives at the beginning of the text. The detail in these particular chapters is very precise, and somewhat laborious to read. I would take as ‘read’ issues such as respect for privacy. Outlining instructions to knock on a door before entering a room are surely unnecessary to put in print. Unfortunately this detail contrasts with later chapters dedicated to medical aspects of care. For example the chapter dedicated to prevention of thromboembolism fails to mention underlying thrombophilia and its management in labour. Guidance on the timing of epidural insertion and removal of the epidural catheter when on LMWH would be useful. The chapter concerned with HIV and Hepatitis B omits Hepatitis B entirely following reference to it in the title. Third degree tears are dealt with in ‘normal labour’ with only a single paragraph—a separate chapter could be dedicated to perineal repair. Illustrations would be welcome. Guidelines for management of emergencies at home are unfortunately lacking in detail. Basic measures such as emptying the bladder, rubbing up a contraction and using bimanual compression can all be used to good effect when faced with unexpected post-partum haemorrhage, but go without mention. It is good that the foetus is not forgotten following delivery—two chapters are dedicated to care of the newborn, and one to breastfeeding and skin-to-skin contact.

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In all, this text has a niche market, namely those doctors or midwives working within the maternity department of King’s College Hospital. Those endeavouring to develop guidelines for their own unit may refer to it, but lack of referencing diminishes its usefulness. Andrew Simm Department of Obstetrics & Gynaecology Nottingham City Hospital, Hucknall Road Nottingham, NG5 1PB, UK Tel.: þ44-115-969-1169x34541; fax: þ44-115-840-2659 E-mail address: [email protected] (A. Simm) 3 April 2003 doi:10.1016/S0301-2115(03)00195-7

Sperm Collection and Processing Methods: A Practical Guide R.S. Jeyendran (Ed.), Cambridge University Press (http:// www.cambridge.org), 170 pp., £45.00 (US$ 65.00), Paperback, ISBN: 0-521-52417-2 The foreword states that this book is intended to be a comprehensive overview and a useful source of reference aimed at clinical and laboratory professionals in reproductive medicine. While the chapters on obtaining sperm from azoospermic men and clinical sperm collection are particularly well presented, and include many highly educational photographic illustrations, much of the remainder of the book fails to deliver. The generally telegraphic style of writing, coupled with an apparent desire to be encyclopaedic but without objective critical comment or expert discussion of the pros and cons of various methods that led to the authors’ recommendations, diminish the real worth of much of the book to the intended target audience. Moreover, the high school biology level of the ‘Introduction’ is well below the knowledge base of the stated target audience and will hold little interest for them. There are too many areas of dissension from published, objective studies and critical reviews, some of which are contrary to the current World Health Organization guidelines on sperm handling and preparation, to debate in a brief book review. In particular, there are a number of unsubstantiated recommendations that are contrary to what is currently established best practice. For example, the authors include recommendations of simple centrifugal sperm washing, both alone and in conjunction with sperm swim-up from the washed pellet, yet there is an extensive body of published evidence and expert opinion that this can be highly deleterious to the sperm (which was even acknowledged by the authors). Surely the purpose of a book such as this is to educate the readers and promote best practice and not continue to promulgate discredited techniques (even if they are still widely used by less specialized laboratories)? For expert opinion to have value it must take readers beyond their current awareness and understanding, something that (with the limited, but welcome, exceptions noted above) this book generally fails to achieve.