Review: Clinical Obstetrics and Gynaecology

[box] James Orr reviews the latest edition of a popular title [/box]

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The latest edition in a successful series, Clinical Obstetrics and Gynaecology is intended to be a core text for both junior trainees and medical students beginning their obstetrics and gynaecology attachments. The title was illustrated by the same artists as Kumar and Clark’s Clinical Medicine and the recognisable style is evident as you progress through the chapters which both aid understanding and break up the text with many detailed diagrams and colour photographs.

The book is split into four sections, covering fundamentals, gynaecology, reproductive health and pregnancy. Chapters in each section relate to common sets of problems or pathology groups, depending on what makes sense for each area and this organisation will seem logical to anyone who has been on and O&G attachment. With chapters on pelvic pain and heavy bleeding but also trophoblastic disease and uterine neoplasia, the book allows a reader to easily home in on specific aspects of the subject without trawling the index. Most chapters can also be easily covered in an hour, perfect for reading up on a topic after coming across it on the wards or for making notes. The organisation of the pregnancy section is excellent in this regard, with nine chapters on labour and its complications. The labour and operative delivery diagrams are very clear, and going through each allows much more understanding of what you are observing on labour ward.

Grasping the basic principles behind a specialty is often key to remembering and understanding the clinical aspects and Clinical Obstetrics and Gynaecology provides a review of fundamentals to begin. The first chapter comprises a comprehensive summary of pelvic anatomy, covering more than is needed to avoid awkward moments under a consultant’s glare in clinic or whilst watching a gynae theatre list, with many schematic diagrams. However, in common with many (or even most) anatomy texts, there are occasions where it does attempt to explain concepts which many students find easier to digest visually.

There are then chapters covering embryogenesis, history and examination and imaging. The embryogenesis chapter is hugely detailed, perfect for those with an interest in the area, or who are using the book as a core text, but perhaps not suitable for refreshing the key pre-clinical concepts. History and examination are covered in a short chapter, with plenty of diagrams clearly showing how each examination technique relates to the anatomy of the pelvis. The History boxes, which appear frequently throughout the whole book, served an extra purpose for me here as knowing the story behind the name of a device often helps with remembering it, and its exact purpose.

In addition, the key points boxes and summaries that conclude every chapter help to clarify the more complex points made in the main body and help the reader to follow – the section on normal and abnormal menstruation being particularly adept at this. Self-assessment sections are now a feature of many textbooks but their absence here is not a problem as there are many other publications available with that sole purpose.

The cohesive design and writing style means that the strengths and flaws are similar throughout, some chapters do suffer from being quite wordy, however the main body is never too difficult to follow. As of yet, this book is not a core text and not one of those recommended for my own course and this is perhaps in part due to its breadth – it often going a fair way beyond what is required to pass undergraduate exams. So, if you are seeking a bullet point revision guide, look elsewhere!

Clinical Obstetrics and Gynaecology is an excellent choice for interested students looking for a first step to gaining an in-depth and well-rounded knowledge of Obstetrics and Gynaecology or for those on attachment looking to cement knowledge gained on the wards with a well-written, superbly illustrated and helpfully laid-out book.

James Orr

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