What is the Handbook of Obstetric Medicine, 6th Edition?
Handbook of Obstetric Medicine, 6th Edition, by Catherine Nelson-Piercy, is a practical clinical reference for healthcare professionals managing medical disorders during pregnancy. Published by CRC Press in 2020, it covers conditions across multiple medical specialties, pregnancy-related diagnostic challenges, clinical management, and differential diagnosis. It is particularly useful for obstetricians, physicians, trainees, and medical students.
Introduction
Pregnancy brings substantial physiological changes that can influence the presentation, investigation, and management of medical conditions.
Hypertension, heart disease, diabetes, renal disorders, neurological problems, and autoimmune diseases may complicate pregnancy, requiring clinicians to balance maternal health with fetal well-being. Recognizing these challenges is essential for healthcare professionals working in obstetrics, internal medicine, emergency care, and related specialties.
Handbook of Obstetric Medicine, 6th Edition, by Catherine Nelson-Piercy, addresses this important area of clinical practice. Published by CRC Press in 2020, the book is designed as a practical, accessible reference for understanding medical disorders encountered during pregnancy and their implications for diagnosis, treatment, and pregnancy outcomes.
Rather than concentrating exclusively on obstetric complications, the book examines medical conditions across multiple organ systems. It explains how pregnancy can affect the presentation and management of existing diseases while also addressing new medical problems that develop during pregnancy.
A dedicated section on differential diagnosis helps readers approach common symptoms, clinical signs, and abnormal investigation results systematically.
The sixth edition retains a two-section structure, combining system-based clinical chapters with tables addressing diagnostic problems in pregnancy. It also includes appendices on prescribing in pregnancy, laboratory reference values, and contraception for women with medical conditions.
This structure makes the book particularly relevant to clinicians who need a concise reference for clinical practice, trainees preparing for examinations, and medical students developing a stronger understanding of maternal medicine.
Whether you are an obstetric medicine trainee, an obstetrician seeking a broader medical perspective, or an internist caring for pregnant patients, this review examines the book's scope, organization, educational strengths, and potential applications.
Book overview
Handbook of Obstetric Medicine
Sixth Edition · 2020
Author: Catherine Nelson-Piercy
Publisher: CRC Press, an imprint of Taylor & Francis Group
Specialty: Obstetric medicine and medical disorders in pregnancy
Intended audience
Obstetricians, physicians, residents, medical students, and other healthcare professionals
Format and organization
System-based chapters, differential-diagnosis tables, practical appendices, and further reading
Publication identifiers
Hardback ISBN: 978-0-367-54102-6
Paperback ISBN: 978-0-367-34612-6
Electronic ISBN: 978-0-429-33076-6
The book identifies Catherine Nelson-Piercy as a consultant obstetric physician associated with Guy's and St. Thomas' NHS Foundation Trust and Imperial College Healthcare NHS Trust and as a professor of obstetric medicine at King's College London. The sixth edition was published in 2020; the publication information also records a 2021 copyright notice.
A separate editor list is not provided in the bibliographic details presented in the book. Catherine Nelson-Piercy is identified as the author.
WHAT THIS BOOK COVERS
The central purpose of the Handbook of Obstetric Medicine, 6th Edition, is to help clinicians understand medical disorders in pregnancy through a structured, system-based approach. The chapters cover clinical features, disease mechanisms, diagnosis, the effects of pregnancy on medical conditions, and management considerations.
The book's coverage extends across 15 system-based chapters, followed by a section devoted to the differential diagnosis of common medical problems during pregnancy.
1. Hypertension and pre-eclampsia
The opening chapter addresses one of the most important areas of obstetric medicine: hypertensive disorders of pregnancy. It covers physiological changes in blood pressure, pre-existing and gestational hypertension, pre-eclampsia, risk factors, diagnostic assessment, and management.
Topics include maternal complications, fetal surveillance, antihypertensive therapy, eclampsia, postpartum care, prevention strategies, and counselling about recurrence in subsequent pregnancies. The chapter also uses summary tables and “points to remember” to reinforce essential concepts.
2. Heart disease
The cardiovascular chapter examines the interaction between pregnancy and cardiac disease. Its listed areas include cardiovascular adaptation to pregnancy, haemodynamic changes during labour and postpartum, pulmonary hypertension, congenital and acquired heart disease, cardiomyopathies, artificial heart valves, arrhythmias, and myocardial infarction.
It also addresses planning for delivery and anticoagulation, making this chapter relevant to clinicians caring for pregnant women with established cardiovascular conditions.
3. Thromboembolic disease
The dedicated chapter on thromboembolic disease provides a place to study blood-clotting disorders in the context of pregnancy. This area is particularly relevant to clinical assessment and management when thromboembolic disease is suspected or when a patient has a pre-existing risk of thrombosis.
The detailed chapter subsections are not enumerated in the general contents listing, so the precise extent of coverage of individual thrombotic conditions cannot be established from that listing alone.
4. Respiratory disease
The respiratory chapter addresses medical problems involving the lungs and respiratory system during pregnancy. It complements the later differential-diagnosis tables on breathlessness and other symptoms by providing a system-based framework for understanding respiratory disease.
5. Diabetes mellitus
The diabetes chapter focuses on a major medical consideration in pregnancy. Its inclusion alongside endocrine, renal, cardiovascular, and other medical specialties supports the book's broader goal of integrating general medical knowledge with pregnancy-specific assessment and care.
6. Thyroid, parathyroid, pituitary, and adrenal disorders
Endocrine disease is addressed in two chapters. The first covers thyroid and parathyroid disorders, while the second focuses on pituitary and adrenal disease.
These chapters provide a dedicated framework for examining endocrine conditions in pregnant patients. Thyroid dysfunction is also revisited in the differential-diagnosis section, which includes a table on abnormal thyroid function tests.
7. Connective tissue disease
The connective tissue disease chapter addresses a group of systemic disorders that may require careful consideration before conception and throughout pregnancy.
This subject is relevant to clinicians who need to understand the relationship between underlying medical disease, pregnancy, and treatment decisions. The book's wider structure also links medical disorders with prescribing considerations and contraception.
8. Neurological problems
The neurological chapter is complemented by diagnostic tables covering headache, seizures, dizziness, collapse, and numbness.
This combination is valuable from a learning perspective because clinicians frequently encounter symptoms before a definitive diagnosis has been established. The book's structure encourages readers to consider a range of potential explanations rather than relying on a single diagnosis prematurely.
9. Renal disease
The renal chapter examines kidney-related medical problems in pregnancy. Renal disease is particularly relevant to the wider assessment of hypertension, proteinuria, abnormal renal function, and acute kidney injury.
The differential-diagnosis section reinforces this topic through dedicated tables on proteinuria and abnormal renal function or acute kidney injury. The appendices on laboratory values and prescribing provide additional reference material relevant to clinical assessment.
10. Liver and gastrointestinal disease
Separate chapters cover liver disease and gastrointestinal disease. The contents also include differential-diagnosis tables for jaundice, abnormal liver function tests, vomiting, and abdominal pain.
This organization helps readers approach symptoms and laboratory abnormalities in a structured way while considering the particular context of pregnancy.
11. Skin disease and hematological problems
The book includes dedicated chapters on skin disease and hematological problems. These subjects broaden the reference beyond the most commonly discussed cardiovascular and endocrine complications.
The inclusion of hematological disease also complements the book's coverage of thromboembolic disorders, although the exact overlap between the chapters should be assessed by consulting the relevant sections.
12. HIV and other infectious diseases
The final system-based chapter covers human immunodeficiency virus (HIV) and other infectious diseases. Its inclusion reflects the importance of recognizing and managing infections as part of comprehensive medical care during pregnancy.
13. Differential diagnosis of medical problems in pregnancy
One of the most distinctive elements of the book is its dedicated section of differential-diagnosis tables.
The tables address:
- Breathlessness
- Palpitations
- Chest pain
- Heart murmurs
- Hypertension
- Abnormal thyroid function tests
- Headache and seizures
- Dizziness and collapse
- Numbness
- Proteinuria
- Abnormal renal function and acute kidney injury
- Pruritus
- Jaundice and abnormal liver function tests
- Vomiting
- Abdominal pain
This section is particularly useful when a clinician needs to organize a diagnostic approach to a presenting symptom or an unexpected investigation result.
14. Practical appendices
Three appendices extend the book's usefulness as a reference:
- Prescribing in pregnancy: a dedicated section on medication-related considerations.
- Normal laboratory values in pregnancy and non-pregnancy: a reference for interpreting investigations in the appropriate physiological context.
- Contraception in women with medical problems: material relevant to reproductive planning and counselling.
Together, these appendices support the book's emphasis on practical decision-making rather than disease descriptions alone.
Key Features
The following features stand out from the book's documented structure and stated educational aims.
- Broad medical coverage: Fifteen system-based chapters address a wide range of medical specialties.
- Consistent chapter organization: Chapters discuss incidence, clinical features, pathogenesis, diagnosis, the effects of pregnancy, and management.
- Differential-diagnosis tables: A separate section organizes common symptoms, signs, and abnormal investigations.
- “Points to remember” boxes: Concise summaries support revision and retention of important concepts.
- Pregnancy-specific reference material: Dedicated appendices cover prescribing, laboratory reference values, and contraception.
- Further reading: The book provides additional reading references, including relevant guidelines where appropriate.
- Examination-oriented utility: The author explicitly identifies trainee revision and examination preparation among the book's uses.
- Clinical reference format: The book is designed to be a pragmatic, easy-to-use guide that clinicians can consult when addressing medical problems in pregnancy.
Who Should Read This Book?
Medical students
Medical students studying obstetrics, internal medicine, or maternal health can use the book to understand how pregnancy affects the assessment and management of medical conditions. Its system-based organization helps connect knowledge from different specialties.
Residents and interns
Residents and interns may find the book useful when encountering medical problems during antenatal assessments, inpatient care, or the postpartum period. The differential-diagnosis tables offer a structured starting point for reviewing possible causes of common symptoms.
Obstetricians and obstetric medicine specialists
Obstetricians can use the book as a reference for medical disorders that complicate pregnancy. Clinicians specializing in obstetric medicine may also benefit from its broad coverage across organ systems and its emphasis on the relationship between medical disease and pregnancy.
Physicians in other specialties
Internists and specialists in cardiology, endocrinology, respiratory medicine, nephrology, neurology, and related fields may find it useful when caring for pregnant patients with conditions relevant to their specialty.
Why This Book Is Useful
Clinical relevance
The book addresses the practical challenge of caring for patients who have existing medical conditions or develop new problems during pregnancy. It also recognizes that clinicians must consider the effects of pregnancy on investigations, medication choices, and disease management.
This makes obstetric medicine a valuable intersection between general medical practice and obstetric care.
Evidence-informed discussion
The author states that the sixth edition's chapters were updated and revised to reflect current understanding and evidence supporting management strategies. The inclusion of further reading and relevant guidelines gives readers opportunities to explore specific subjects in greater depth.
However, the publication date matters: the sixth edition appeared in 2020. Some recommendations, drug information, or clinical guidelines may since have changed. Readers should verify time-sensitive decisions using current professional guidance.
Practical applications
The combination of system-based chapters, differential-diagnosis tables, and appendices makes the book useful for several kinds of learning:
- Reviewing a medical condition before a clinical encounter.
- Revising the differential diagnosis of a presenting symptom.
- Studying how pregnancy influences the assessment of a medical disorder.
- Reviewing pregnancy-related prescribing considerations.
- Preparing for discussions about medical conditions and reproductive planning.
Board and postgraduate examination preparation
The book's concise reference approach and summary boxes can support revision for postgraduate examinations and clinical assessments.
Its strongest role is as a supplementary resource. Candidates should compare its coverage with their specific examination blueprint and use appropriate question banks, current guidelines, and other learning materials where needed.
Learning efficiency
The two-section structure allows readers to approach a topic in more than one way. A reader studying renal disease can begin with the renal chapter, while someone investigating proteinuria can turn to the relevant differential-diagnosis table.
This flexibility is particularly helpful for clinicians who need to move between systematic study and targeted reference during a busy clinical schedule.
Table of Contents Overview
The book is organized into two principal sections, followed by three practical appendices.
|
Section or chapter |
Main subject |
|
Section A: Systems |
Medical disorders organized by organ system |
|
Chapter 1 |
Hypertension and pre-eclampsia |
|
Chapter 2 |
Heart disease |
|
Chapter 3 |
Thromboembolic disease |
|
Chapter 4 |
Respiratory disease |
|
Chapter 5 |
Diabetes mellitus |
|
Chapter 6 |
Thyroid and parathyroid disease |
|
Chapter 7 |
Pituitary and adrenal disease |
|
Chapter 8 |
Connective tissue disease |
|
Chapter 9 |
Neurological problems |
|
Chapter 10 |
Renal disease |
|
Chapter 11 |
Liver disease |
|
Chapter 12 |
Gastrointestinal disease |
|
Chapter 13 |
Skin disease |
|
Chapter 14 |
Hematological problems |
|
Chapter 15 |
HIV and other infectious diseases |
|
Section B: Differential diagnosis |
Tables covering common medical problems in pregnancy |
|
Appendix A.1 |
Prescribing in pregnancy |
|
Appendix A.2 |
Normal laboratory values in pregnancy and non-pregnancy |
|
Appendix A.3 |
Contraception in women with medical problems |
The printed contents place Section A at the beginning of the book, followed by the differential-diagnosis tables and appendices. The index begins on page 351 of the printed pagination.
This arrangement allows readers to move between comprehensive topic-based study and focused consultation of a particular symptom or investigation.
Strengths of the Book
1. A broad, integrated approach to obstetric medicine
A major strength of Handbook of Obstetric Medicine, 6th Edition is its coverage of medical conditions across multiple organ systems. Rather than limiting the discussion to a narrow group of pregnancy complications, it brings together cardiovascular, respiratory, endocrine, renal, neurological, gastrointestinal, haematological, and other medical topics.
This breadth is useful for clinicians who need to recognize how diverse medical problems may affect pregnancy care.
2. A structure designed for clinical reference
The consistent chapter framework makes the material easier to navigate. Readers can approach a condition through its clinical features, pathogenesis, diagnosis, effects on pregnancy, and management.
This is a practical design for clinicians who need a focused review of a subject without treating the book solely as a cover-to-cover textbook.
3. Strong emphasis on differential diagnosis
The dedicated differential-diagnosis section is an important educational feature. Symptoms such as chest pain, breathlessness, headache, and abdominal pain can require consideration of several possible causes.
By organizing these presentations into tables, the book provides a useful companion to the system-based chapters.
4. Support for revision and knowledge retention
The “points to remember” boxes provide concise summaries of key concepts. These are useful for revisiting important information after studying a chapter and for identifying topics that need further review.
5. Attention to prescribing and reproductive planning
The appendices on prescribing in pregnancy, laboratory values, and contraception extend the book's practical scope. These subjects are closely related to the decisions clinicians make when caring for patients with medical conditions before, during, and after pregnancy.
6. Further-reading recommendations
The inclusion of references for additional study helps readers explore selected subjects beyond the concise handbook format. The preface also directs readers toward relevant professional resources and guidance where appropriate.
Overall, these strengths make the book particularly suitable as a supplementary clinical reference and structured learning resource.
Limitations
A balanced review should also consider the book's boundaries.
- Publication date: The sixth edition was published in 2020. Readers should check current guidelines, formularies, and clinical recommendations before relying on it for contemporary treatment decisions.
- Reference-book format: A concise handbook cannot replace detailed specialist textbooks, primary research, or comprehensive clinical guidelines for every complex presentation.
- Specialist depth varies by need: Readers seeking an exhaustive account of a narrow subspecialty topic may need more specialized resources.
- Clinical judgement remains essential: The book's publisher explicitly cautions that its guidance supplements professional judgement and that information about diagnoses, procedures, and drug dosages should be independently verified.
- Audience-specific coverage: Although the book may benefit several healthcare professions, it is primarily framed as a medical reference. It is not presented as a separate nursing, pharmacy, or patient education textbook.
- Edition-specific information: The extent to which individual recommendations have been revised since publication cannot be established without comparing the book with later guidance and editions.
These limitations do not negate the book's educational value. They clarify how it should be used: as a reference that supports, rather than replaces, current evidence, clinical experience, and professional guidance.
Comparison With Similar Books
Handbook of Obstetric Medicine, 6th Edition occupies a practical reference niche within medical education. Its defining characteristics are the combination of system-based chapters, pregnancy-specific clinical discussion, differential-diagnosis tables, and focused appendices.
Compared with broader obstetrics textbooks, its organization places particular emphasis on medical disorders affecting pregnancy rather than attempting to cover the entire field of obstetrics. Compared with comprehensive internal medicine textbooks, its focus is narrower and more specifically concerned with the interaction between medical disease and pregnancy.
Compared with detailed specialty references, its concise handbook approach is better suited to targeted review than to exhaustive investigation of every subspecialty question. These are comparisons of scope and format, not claims of superiority.
FAQs
It is a clinical reference covering medical disorders that occur during or affect pregnancy. It addresses conditions across multiple organ systems, with discussions of clinical features, pathogenesis, diagnosis, pregnancy-related effects, and management, followed by differential-diagnosis tables and practical appendices.
The author is Catherine Nelson-Piercy, a consultant obstetric physician and Professor of Obstetric Medicine at King's College London, as identified in the book's publication details.
It is intended primarily for clinicians caring for pregnant women, including obstetricians, physicians, residents, and trainees. Medical students, other healthcare professionals, educators, and examination candidates may also find it useful as a supplementary reference.
The book covers hypertension and pre-eclampsia, heart disease, thromboembolic disease, respiratory disease, diabetes, endocrine disorders, connective tissue disease, neurological problems, renal and liver disease, gastrointestinal and skin disease, haematological problems, HIV, and other infections.
Yes. The author specifically describes its use by trainees for examination revision. The system-based chapters, summary boxes, and differential-diagnosis tables can support preparation, but candidates should also consult their examination syllabus and current clinical guidance.
Yes. Section B is devoted to tables on common medical problems in pregnancy, including breathlessness, chest pain, palpitations, headache, seizures, proteinuria, abnormal renal function, jaundice, vomiting, and abdominal pain.
Yes. Appendix A.1 is dedicated to prescribing in pregnancy. Appendix A.2 addresses normal laboratory values in pregnant and non-pregnant patients, while Appendix A.3 covers contraception in women with medical problems.
For actual prescribing, readers should independently verify current recommendations and drug safety information.
It can be useful for foundational learning and clinical reference, but it was published in 2020. Medical recommendations may have changed since publication, so clinicians should check current guidelines, drug formularies, and institutional protocols before making patient-care decisions.
Conclusion
Handbook of Obstetric Medicine, 6th Edition, by Catherine Nelson-Piercy, is a broadly focused clinical reference for understanding medical disorders in pregnancy. Its combination of system-based chapters, differential-diagnosis tables, concise summaries, and practical appendices makes it useful for clinicians who need to connect general medical knowledge with the specific demands of pregnancy care.
The book is particularly well suited to obstetric medicine trainees, obstetricians, residents, medical students, and physicians managing pregnant patients with medical comorbidities. Its structured presentation also supports postgraduate revision and targeted review of common diagnostic problems.
Its principal value lies in the way it organizes a wide range of medical topics into an accessible reference format. Readers can study an entire clinical subject or quickly consult a table when reviewing a symptom or abnormal investigation.
Because the sixth edition was published in 2020, it is best used alongside current clinical guidelines and prescribing references rather than as the sole authority for treatment decisions.
For healthcare professionals seeking a structured introduction to, or a practical refresher in, obstetric medicine, Handbook of Obstetric Medicine, 6th Edition is a relevant supplementary resource to consider.