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Clinical cases in obstetrics, gynaecology and women’s health

By Caroline De Costa, Stephen Robson and Boon Lim

McGraw Hill Education, RRP $55, pp316

ISBN 978-1-7430-77-2

McGraw Hill Education is offering Australian Medicine readers 15 per cent off purchase price when they buy online using Promo Code: DECOSTA13

Review by Gino Pecoraro*

Clinical cases in Obstetrics, Gynaecology and Women’s Health is a handy A5-sized pocket textbook suitable for medical students, general practitioners and early year obstetrics and gynaecology registrars.

This easy-to-read and portable primer of women’s health is filled with simple, frequently unwritten information like positioning of patients when examination is difficult, as well as guidelines for the diagnosis and management of common issues like gestational diabetes.

Scattered throughout the text are reminders that patients are more than just clinical problems. Embedded in any treatment plan is recognition and acknowledgement of associated emotional and social needs. 

Part one concentrates on the vital background information on how to take an effective and complete obstetric and gynaecological history, as well as what is involved with a gynaecological examination in an adult.

Each section starts with a life-like clinical scenario. It may be a patient asking for advice, someone presenting with specific symptoms or the reader being faced with a clinical emergency.

These scenarios are representative of the full scope of women’s health practice, including management in pregnancy and labour, fertility issues and gynaecological problems later in life.

From acne, unexpected pregnancy, questions around safe sex and amenorrhoea through to twin pregnancy, placental abruption, pain relief in labour and elective Caesarean section – most frequently encountered subjects are covered.

There’s also a case covering prolapse and urinary incontinence.

This problem-based learning approach is a continuation of methods used in modern medical education, and should feel familiar and comfortable to the junior doctors the book is aimed at.

Using a series of patient questions to stimulate thought, the reader is guided through history, examination, investigation and treatment.

Interspersed throughout the text are important pieces of theoretical knowledge explaining why a particular course of investigation or treatment is required.

In some cases, prompts to remind the reader to ask for important collateral history are included and help ensure all avenues of the potential case are explored and dealt with.

Tables, illustrations and photographs are presented where appropriate to consolidate important factual information and illustrate important surgical techniques such as repair of episiotomy.

By working through each case in a logical fashion, the reader is encouraged to be an active participant in the care of the patient rather than reading lists of differential diagnoses, investigations and treatment.

Where multiple options are available, they are expanded upon and reasons for choosing one over another offered.

At the end of each clinical scenario, a section entitled “clinical pearls” provides a summary of important learning points around the topic.

These pearls include information such as incidence rates of common problems, brief targeted discussions of pathophysiology and sensible advice on treatment options.

For potentially life-threatening scenarios like primary postpartum haemorrhage, easy to follow flowcharts detailing investigation and treatment (including asking for help) provide a one-stop reminder for junior staff members in a stressful situation.

Doses for frequently used drugs, especially in emergency situations, are not always given throughout the text and I would recommend this be considered as an addition in future editions to make the textbook truly all-inclusive and self-sufficient for junior medical staff. 

All in all, this book provides an excellent summary and easily portable resource for any medical student or junior doctor to use during a women’s health term.

Information is provided in an easy-to-read and rapidly accessible format, with practical advice from the authors that clearly reflects their extensive real-life clinical experience in the field.

 

* Dr Pecoraro is a Brisbane-based obstetrician and gynaecologist, a past President of AMA Queensland, and represents the Obstetrician and Gynaecologist Craft Group on the AMA Federal Council

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