Obstetrics and Gynaecology

Lawrence Impey
Oxford: Blackwell Science, 1999; £24.95
ISBN: 0632048425

Mark James, Tim Draycott, Robert Fox, and Michael Read
London: W B Saunders, 1999; £19.95
ISBN: 0702022519

Undergraduates in obstetrics and gynaecology have been crying out for a new textbook for years. This was one of the subjects where there was nothing that was quite suited to the needs of medical students. Books for the Diploma Royal College of Obstetrics and Gynaecology were all words, no pictures, and a bit more than we needed to know. Others, such as Ten Teachers, did not always contain enough detail.

Then came Impey, and, in the manner of the London bus, James et al arrived at the same time. Suddenly there are two good texts for undergraduates. Impey's book is my favourite - 100 pages of gynaecology followed by 120 pages of obstetrics. All the big topics are covered systematically, and plenty of boxes provide the answer to the "five causes of vaginal discharge" type question without having to labour through the text. Each chapter ends with "at a glance" summaries which cover the major points dealt with by each chapter. One of the most useful sections of Impey's book is the management section at the back. This is ideal revision for objective structured clinical exams - it deals with all the common presenting complaints, suggests possible causes, important aspects of the history, examination, and investigations, and then offers some management options.

Other aspects worthy of note include the diagrams - they are always clear and well labelled (reviewing the book on the train was sometimes an embarrassing experience). Impey has made use of many ultrasound images, but they are always accompanied by line drawings that decode the snowstorm. There is a handy list of abbreviations at the beginning of the book, but the list contains some significant omissions (even sometimes of abbreviations used in the text). The book recently failed to win at the BMA book awards, and this may have had something to do with the lack of polish that pervades throughout - no doubt this will be refined for the second edition along with the few mistakes in the text. Perhaps Impey's weakest point is the index - all too often it is difficult to find what you are looking for. Despite these weaknesses, this is a great book which could certainly be labelled as the only book needed to pass finals in obs and gynae.

James et al call their book a problem solving approach, and most chapters indeed focus on a clinical problem such as non.menstrual vaginal bleeding, unlike Impey's more didactic "disorders of the menstrual cycle" and "the uterus and its abnormalities." James et al start with a section called "outline of clinical practice," which struck me as a confusing lists of facts, management instructions, and do's and don'ts. This sits uncomfortably with the problem centred approach used throughout the rest of the book. The diagrams are neither as frequent nor as clear as Impey's, and ultrasounds are not accompanied by the snowstorm decoding diagrams. A useful feature are the "differential diagnosis" boxes that head each chapter and the "golden points" boxes that summarise them. The index, although far from perfect, is a vast improvement on Impey's. Certainly this is a good book, but it is not a great book, and for me it is Impey who has the edge.

Progress in obstetrics and gynaecology is a book for honours candidates. It is one of those books you borrow from the library to garner facts to impress your consultant. It contains 25 articles on the latest developments in various aspects of the specialty, and is certainly not an undergraduate textbook. This edition contains interesting articles on management of post.menopausal bleeding, different routes of HRT administration and the management of breech at term. This is not a book that undergraduates need to buy, and it probably won't help you to pass finals. It is, however, an easily accessible source of "breaking news" in the subject and would be an ideal starting point for those with a very strong interest in obs and gynae.

Nick Jenkins, chairman, Medical Students' Committee, BMA, London


studentBMJ 2000;08:45-88 March ISSN 0966-6494