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Congenital and perinatal infections prevention, diagnosis and treatment
  1. M Sharland1
  1. 1Department of Paediatrics, St George's Hospital, London SW17

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    Ed by Marie-Louise Newell, James McIntyre. £37.95; Pp 342. Cambridge: Cambridge University Press, 2000. ISBN 0 521 78979 6.

    I liked this book. An alternative title could be “An evidence based review of prevention, diagnosis, and treatment of congenital and perinatal infection.” The editors, both recognised experts in perinatal infection, persuaded an international panel to provide up to date reviews of particular perinatal infections with key references up to 1999/2000. Despite clearly a short production time an inevitable weakness is that new data have become available after going to press. To keep costs down there are few illustrations and a lot of text. However, tables are widely used and the text is well broken up. One third of the book is devoted to references, so all the text is strongly evidence based, and statements are not based on authors' opinion but on published literature.

    There is an excellent introduction on the interaction between pregnancy, immunity, and infection and a thorough discussion on maternal infections and their consequences. This section ends with a review of the pitfalls and benefits of screening for antenatal infections including an excellent summary of the potential biases involved in setting up and evaluating screening programmes.

    The second section is a traditional whizz through the standard common infections in pregnancy. Highlights include Forsgren and Malm's excellent chapter on herpes simplex infection, and Mandelbrot and Newell's thorough review of vertical transmission of hepatitis viruses. I was disappointed to see no detailed discussion of HTLV-I infection or a more detailed review of the role of perinatal infections in cerebral palsy.

    Two other criticisms could be a relative lack of assessments of cost effectiveness of screening programmes already in place and for the future. The introduction of new screening programmes and the retention of existing screening programmes—for example, syphilis and rubella, need to be increasingly driven by cost-benefit analysis. It would also be interesting to have had some speculation about why different infections have such different vertical transmission rates and have their impact at different stages of pregnancy.

    Overall, the strength of this book lies in its literature reviews. It is an extremely good summary of where we are at with perinatal infections in the year 2000. Who will find it useful? It is a postgraduate text, too detailed for undergraduates. It should be compulsory reading for obstetricians in training. I would recommend it to perinatologists, obstetricians, and genitourinary medicine physicians. It is a practical text with dosages, immunisation schedules, and treatment algorithms. It is reasonably priced. There are larger textbooks on perinatal infections costing £200, so this fills a gap in the market. Buy it and you won't be disappointed.

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