84 Book reviews

dose or potency of the medication. The dysfunction was not transient but showed up as strongly after one month of life as it did during the neonatal period.

Juchan (Wachington, D.C., USA) describes the central role of cytochrome P-450 in oxidation reac- tions in the feto-placental unit. Placental transfer of drugs and effects on the fetus and newborn is dis- cussed for gentamycin.

Michael1 Heymann, Kari Teramo and Abraham

Rudolph (San Francisco, Calif., USA) described the

effects of local anesthetic agents on fetal circulation. In chronic sheep experiments they found dose-de-

pendent effects of local anesthetics and fetal myo- cardial depression as well as direct central nervous system effects. When administered as a paracervical block, the rate and concentration of delivery of the drug to the fetus was variable and not predictable.

Else Ackermann and Klaus Richter (GDR) showed that the rate of conversion of diazepam is lower in fetal than in adult human liver tissue so that one may expect an accumulation of diazepam metabolites on the fetal side.

Neonatal studies are presented on salicylate phar-

macokinetics, phenobarbital, phenytoin, carba- mazepine, digoxin, cefalotin, drug protein binding and diurnal variation of drug kinetics.

The Symposium ends with ethical and methodo- logical challenge in research in perinatal pharmacol-

ogy. This book is strongly recommended to all those in-

terested in and concerned about medication during pregnancy, labor and the neonatal period.

T.K.A.B. Eskes, Nijmegen

Die Ultraschalldiagnostik in der Schwangerschaft

H.J. Hollander (ed.) Urban und Schwarzenberg, Miinchen-Berlin- Wien, 1975 (xi + 188 pp., 1 I2 Figs., 7 Tables) DM 58.-

Three years after the publication of the first edition of this handbook for diagnostic ultrasound in obstet- rics, a second edition has already been produced. From the outset this well-documented work has at- tracted much attention.

Indeed, the growing use of diagnostic ultrasound techniques, also in smaller hospitals, creates the need for good documentation.

This book contains much personal research, as a result of which the novice especially obtains a clear view of the diagnostic possibilities in obstetrics.

In the first chapters the authors deal at great length with the basic principles of the ultrasound employed, with a description of the various tech- niques in use. Fortunately they do not confine them-

selves to the apparatus they used (Vidoson, Siemens); also describe other commercially available equipment.

The biological effect of ultrasound and the pos-

sible harmful side-effects are described in detail, with references to other publications, including recent ones. The whole field of diagnostic ultrasound as ap- plied in obstetrics is discussed; the book has been brought very up-to-date by adding references to re- cent publications. A great deal of attention is devoted to fetal biometry: determination of the fetal bipari- eta1 diameter, measurement of fetal abdomen and trunk circumference and placental thickness. In connection with this the authors invariably present their own growth curves and normal values. These val- ues must be used with the greatest caution, because on the one hand each local population may be bio- logically different, and on the other hand the individ- ual growth of normally developing fetuses may vary widely. A striking recurrent feature in the discussion of clinical applications is the amount of attention paid to obstetric background and the way in which diagnostic ultrasound techniques should be included in clinical examination. It is this very feature which makes this handbook very valuable as a reference work.

The Vidoson technique employed entails the draw- back that the illustrations are frequently not very sharp and that hardly any space has been reserved for the modern, very fine grey-scale technique.

For all those who employ diagnostic ultrasound this book is greatly recommended.

T.M. Hameeteman, Vleuten

Gerinnungsanalysen Interpretation, Schnellorientierung, Therapiekontrol-

len