Treating for two

In a large multi-authored text, editorial oversight is important to maintain uniformity of style and distribution of priorities. There has been some laxity here, with idiosyncratic chapter length, detail in coverage and placement of topics. The chapter on pulmonary disease is more than three times the length of that covering renal disease. This does not reflect clinical reality. Eclampsia is dealt with in the neurology chapter rather than with pre-eclampsia, and cholestasis of pregnancy is detailed correctly in the liver chapter, but also at length in the dermatology chapter. A detailed scientific treatise on the immunology of pregnancy has no practical utility, and need not appear in this clinical text, and the impassioned coverage of smoking in pregnancy appears in the “Pulmonary” rather than “Substance Abuse” chapter. However, the full gamut of medical disturbances that are seen in pregnancy is well covered. Appropriately sandwiched between “Genetics” and “Emergency management” is a discourse on “Ethical issues in obstetrics”. Though interesting, it has no specific relevance to the book. A chapter dealing specifically with implications for the infant of maternal medical disease would have been more useful.