of administration of inotropic agents in the
first week of life in LBW infants.

There is still uncertainty about the effect of
prenatal steroids on various extrapulmonary
outcome variables. As the positive effect of
maternal administration of steroids on neo-
natal respiratory distress syndrome has been
repeatedly demonstrated, a randomised con-
trolled trial approach to assess the effect of
prenatal steroids on these extrapulmonary
outcome variables is no longer ethical or
feasible. However, prospective collection of
these variables, as was done by both groups
mentioned above, is still of clinical relevance,
especially if we take into account that the large
randomised controlled trial studies were
performed in the 1980s and 1990s and there-
fore potentially only in part reflect the
populations admitted to our present day units.

K Allegaert, A Debeer
University Hospital, Gasthuisberg, Belgium

Correspondence to: Dr Allegaert; karel.allegaert@uz.
kuleuven.ac.be

References

1 Vural M, Yilmaz I, Oztunc F, et al. Cardiac effects
of single course antenatal betamethasone in
preterm infants. Arch Dis Child Fetal Neonatal Ed
2006;91:F118–22.

2 Dimitriou G, Kavvadia V, Marcou M, et al.
Antenatal steroids and fluid balance in very low
birthweight infants. Arch Dis Child Fetal Neonatal
Ed 2005;90:F509–13.

3 Allegaert K, Debeer A, Cossey V, et al. Dopamine
is not an independent risk factor for reduced
amikacin clearance in extremely low birth weight
infants. Pediatr Crit Care Med 2006;7:143–6.

doi: 10.1136/adc.2006.095943

Funding: the clinical research of KA is supported by
the fund for Scientific Research, Flanders, Belgium by
a clinical doctoral grant (A 615-KV-G1).

Competing interests: none declared

BOOK REVIEWS

I approached this book with interest after a
rash of congenital and acquired infections
locally. The book is divided into two sections,
the first tackling the sometimes baffling array
of serological, immunological, and molecular
tests simply but thoroughly. An excellent
chapter on placental pathology reminds the
reader of how much information this often
overlooked organ can yield.

The second part of the book deals with
specific infections, and the chapters are pre-
sented in a standard format which makes
dipping in and out easy, despite the almost
wall to wall text. The emphasis of this book is on
diagnosis, but there is also considerable infor-
mation on epidemiology, transmission risks,
and clinical features of each infection.
However, from a clinician’s perspective, it is
frustrating that the authors chose not to include
the areas of management and outcome as they
are ‘‘well detailed in many other sources’’.

Although the epidemiological emphasis is
on the United States, the author extends
appeal to the developing world, and chapters
include the diagnosis of malaria, syphilis, and
tuberculosis. In contrast, common bacterial
infections are given little coverage, except a
good chapter on group B Streptococcus and the
controversies surrounding screening and treat-
ing. Disappointingly, the coliforms are dealt
with in a single short paragraph, and coagulase
negative Staphylococcus does not receive a
mention, despite being the most common
neonatal pathogen across the developed world.
Moreover neonatal tetanus, which accounts
for 7% of all early neonatal deaths world wide,
is ignored. Instead two chapters are dedicated
to the epidemiology and diagnosis of congeni-
tal lymphocytic choriomeningitis and dengue
virus, of which there are only a few small case
series in the literature.

The book is heavy on text with a few tables,
and only two conditions are illustrated with
poor quality black and white photographs.
Priced at £75, colour photographs would have
been welcome, particularly as the emphasis
throughout is on laboratory diagnosis in
conjunction with clinical signs.

The strength of this book is the diagnostic
expertise and would undoubtedly be found
most useful by microbiologists in the perinatal
field. It provides good information on epide-
miology, range of appropriate tests, risks to
mother and fetus, and spectrum of clinical
features. Such detail would be invaluable for
those developing a perinatal microbiological
service. However, this book will fall short in
many perinatologists’ eyes in not providing
guidance on treatment and information on
outcome, both of which could have been
handled reasonably succinctly at the expense
of some of the more exceptional diseases.

J-C Becher

Intensive care of the fetus & neonate,
2nd edn
Edited by Alan R Spitzer. Published by Elsevier,
2005, £99.00, pp 1472. ISBN 1560535121

As I was on the look out for a good reference
book on neonatology, this book crossed my
path at just the right time. As a basic
reference text it did not disappoint. I was
particularly impressed with the good ground-
ing it provides in fetal medicine as well as
covering neonatal intensive care. Although
on the whole I like the book a lot, it does not
quite meet my expectations in terms of the
comprehensiveness of its subject matter.

The book starts well with an interesting and
informative history of fetal and neonatal inten-
sive care. It then moves on to chapters covering
fetal development, assessment, diagnosis, and
intervention. These chapters, along with the
subsequent sections on maternal factors
influencing neonatal outcome and manage-
ment of the high risk pregnancy, are a fantastic
resource for those who, like me, are somewhat
rusty when it comes to the intricacies of fetal

medicine. I enjoyed reading these chapters and
am likely to refer to them repeatedly.

Logically enough, the text moves on to give
a good, robust coverage of neonatal resusci-
tation and newborn examination. Following
this, the lion’s share of the book is concerned
with neonatal intensive care. This is intro-
duced by a rather hotchpotch mix of chapters
on radiology, thermal regulation, and the
evolving role of nurse practitioners, which
have been squeezed in before the major
chapters covering body systems. As an aside,
this is not the only place in the book where
the topic order might be felt to be slightly
unusual or counter-intuitive.

The chapters on body systems give detailed
coverage of all of the more common and
important neonatal conditions. They also give
important consideration to related topics
such as different modes of ventilation (which
are given a chapter each), follow up of the
high risk neonate, nutrition, fluid and elec-
trolyte physiology, and transfusion therapy to
name a few. To complete the book, there are
sections on surgical management of the
neonate, which concentrate on general surgi-
cal care issues and urological problems,
followed by a brief look at some epidemiolo-
gical and ethical considerations.

At first glance, the book seems to be fairly
comprehensive, but, on closer examination, I
felt that there was less mention of several organ
systems than I would have liked: there are no
chapters specifically covering neonatal derma-
tology or orthopaedic problems, for example. I
was also surprised to find several conditions
notable by their absence. To confirm this
impression, I looked up a random selection of
conditions that I had encountered in the
neonatal intensive care setting in the last five
years. Conditions from this list that I did not
find in the book included Edward syndrome
(trisomy 18), CHARGE syndrome, epidermoly-
sis bullosa, and osteogenesis imperfecta.

On the whole I really liked this book and
feel it will be a useful addition to my reference
collection. It probably caters better for those
looking for a broad overview of fetal and
neonatal intensive care than for those who
want a more fully comprehensive text that
includes less common neonatal problems.

C L Smith

Congenital and perinatal infections:
a concise guide to diagnosis
Edited by Cecilia Hutto. Published by The
Humana Press, 2005, £70.00, pp 328 (hard-
back). ISBN 1588292975
Having been taught from an early and
impressionable age that the first answer to
most questions in neonatology is ‘‘infection’’,
it is discouraging that, despite many years of
advances in neonatal intensive care, the
diagnosis and treatment of infection remains
a considerable challenge. This is particularly
true of the extreme preterm infant, whose
improved survival is accompanied by an
increase in nosocomial infections. Many
units throughout the world have seen an
extension of the antimicrobial repertoire as
organisms become increasingly resistant to
conventional broad spectrum antibiotics.

doi: 10.1136/adc.2005.090670corr1

M E Abdel-Latif, B Bajuk, J Oei, et al. (Arch
Dis Child Fetal Neonatal Ed 2006;91:F251–6).
The author list for this paper should be:
M E Abdel-Latif, B Bajuk, J Oei, T Vincent,
L Sutton, K Lui, and the NICUS Group.

CORRECTION

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