A first edition of the Obstetric Anesthesia Handbook published in 1992 was well-received. The author, Dr. Sanjay Datta, was director of Obstetric Anesthesia at Brigham and Women’s Hospital, Harvard University. In the preface to the second edition, Dr. Datta, states that the handbook “was written to serve those interested in gaining the basic concepts of treating pregnant patients”.

This handbook, which features a well-organized overview of the clinical issues of obstetric anesthesia, has been popular as a source of ready information in the case room and as a valuable student reference for examination preparation. In the fourth edition in 2006, the original format was preserved, the contents were updated to reflect interval changes, and the American Society of Anesthesiologists’ (ASA) practice guidelines were appended. Dr. Datta remained as sole author.

The Obstetric Anesthesia Handbook, Fifth Edition (2010) represents a renewal of this work. Drs. Segal and Kodali, two colleagues and former students of Dr. Datta, have joined as co-authors. While the authors preserved the original format, this edition introduces updated references and tables for existing topics, as well as the addition of certain new chapters.

A new feature of this fifth edition is an expansion of the material on high-risk pregnancy into two chapters. One chapter addresses issues of maternal co-morbidities, while a second chapter outlines pregnancy-related problems. Each chapter has a current bibliography for further reading, and clinical context is also provided. For example, the authors refer to their institutional database when describing decision-making with regard to the use of regional anesthesia in thrombocytopenic patients.

The non-pharmacological methods of pain relief during labour have been reorganized and updated into a separate chapter, as has a chapter on systemic medications and inhalational agents for pain relief in labour. A chapter on neonatal resuscitation features a succinct overview of the topic.

The following current guidelines are appended: 1) the ASA Guidelines for Regional Anesthesia in Obstetrics (2007); 2) Practice Guidelines for Obstetrical Anesthesia, an Updated Report by the ASA Taskforce on Obstetric Anesthesia (2007); and 3) Optimal Goals for Anesthesia Care in Obstetrics (2007), a joint statement from the ASA and the American College of Obstetricians and Gynecologists (ACOG). Anesthesiologists who have administrative responsibilities for obstetric anesthesia services may find this information useful.

The Obstetrical Anesthesia Handbook, Fifth Edition should be recommended as an introductory reference text for medical students and residents in Anesthesia programs, and as a reference for the anesthesiologist required to provide obstetrical anesthesia care and neonatal resuscitation in daily practice.