Early Human Development, 8 (1983) 71-81 si: Elsevier Science Publishers

Book reviews

77

Fetal and Neonatal Pathology Edited by A.J. Barson Praeger Scientific Publishers, 1982 262 pages + x, E13.50

It is interesting that a book on perinatal pathology should be published under the aegis of the Royal College of Pathologists when, in the opinion of this reviewer at any rate, that body is passively if not actively conniving in the demise of the specialty-to the great loss of the related disciplines of obstetrics, clinical genetics and neonatal paediatrics; but perhaps we should be grateful when even the ranks of Tuscany provide some cheer for those who hold the pass. This book is the edited proceedings of a symposium held in Birmingham in 1981 for General Pathologists having responsibility for perinatal post mortem examinations; and like any other banquet, it involved the serving up of a restricted menu of dishes not all of which turned out successfully on the day or can be recreated by reading an account of it - however well edited, illustrated and produced as this one is.

Part I of the book comprises a number of papers on fetal pathology. The first by Duncan Gough, on the diagnosis of fetal abnormalities by the obstetrician, is mainly devoted to ultrasound imaging and is more of a catalogue of what can be done than an instruction manual on how to do it. Colin Berry, in the second, provides a rather perfunctory account of the human malformations and their known causes; while in the third, Dr. Rushton deals with the examination of abortions (saying nothing, incidentally, about how we make use of so-called social abortions to discover more about the supposedly normal fetus). In the fourth and fifth papers, McDermott and Lawrence describe respectively antenatal screening for chromosomal disorders and for neural tube defects; the first concentrating mainly on the conditions that can be uncovered in this way, the latter on the techniques in present use. The sixth paper, by Patrick, reviews the present state of the art of detecting metabolic defects in the fetus in utero; the seventh, by Elizabeth Lesky, deals with the haematological problems affecting, or demonstrable in, the fetus. The last paper in this section, by Poswillo, is about prospects and achievements in fetal surgery, making out quite a good case for the detection and correction of some abnormalities before birth if babies are not to be born with problems too advanced for complete cure yet not likely to be immediately fatal.

The second section is concerned with neonatal pathology, sensu stricto, beginning with a sensible introduction by the doyen of British neonatologists, Sir Peter Tizard, and continuing with a useful account by the editor of the perinatal post mortem examination. In the third paper Jean Golding gives some helpful information about who carries out such examinations in this country at the present time, making it

78

clear that few areas can emulate Manchester in having most of their perinatal post mortems done by someone trained in the relevant art and science. There follows a learned and thoughtful account by Professor Fox of the value of placental examina- tion-perhaps the high-light of the book; a workman-like paper on the assessment of maturity and viability around the time of birth by John Emery, a rather nondescript little chapter on prematurity by Gibson, a very practical guide to the pathology of congenital heart disease by Anderson and Ho, a no more than adequate description of the iatrogenic conditions resulting from intensive care by Fagan, and a less than adequate catalogue of infection in the newborn by George, which does not deal with the important viral infections that can be contracted in the birth canal or soon after birth.

Who is this book intended for? Not, I think, paediatric pathologists, nor general pathologists looking for a comprehensive guide on how to carry out this part of their responsibilities when thrust upon them. It would be useful reading for a senior medical student trying to decide in which field to pursue his career and it ought to be compulsory reading for Officers of the Colleges of Pathology and of Obstetrics and the British Paediatric Association, and for Mrs. Short *. Much of the material is necessarily ephemeral and one wonders whether it would be a good investment for a library at the usual fairly steep price charged these days for medical textbooks. Perhaps this is as good an opportunity as any for questioning the present fashion for publishing the proceedings of meetings, which, as your reviewer sees it, serve a different purpose than the book on the shelf with its implication that it belongs to Poppers’ third world of knowledge. But was it Pliny who said that no book is so bad that most men will not be the wiser for reading it, and this one is good of its kind and includes some material of great interest and importance.

J.A. DAVIS

* * *

Tubal Infertility - Diagnosis and Treatment Geoffrey Chamberlain and Robert Winston (Eds.) Blackwell Scientific Publications, 1982 162 pages, f15.00

This is an easily read, almost pocket-size book of 150 pages aimed at surgical gynaecologists. There are nine shortish chapters, all but one contributed by British authors. The remaining chapter comes from the Microsurgery Centre, Academisch Ziekenhuis, Leuven.

* Mrs. Ren6e Short, M.P., Chairman of a House of Commons Select Committee which recently studied perinatal services in Great Britain - Ed.