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This is a wonderful little book and should be essential reading for anybody preparing for Part 2 of the Membership of the Royal College of Obstetricians & Gynaecologists. It is also a useful source of information for practising gynaecologists who find themselves barracked by patients to provide evidence-based statistics for suggested clinical management plans.
The book has six multiple choice papers with 300 questions in each followed by an answer section with justification. Questions are clinically based and broadly correct. The authors can be forgiven the occasional lapse. The margins of opinion occasionally overlap scientific bias, as in Paper 4, a patient at 12 weeks of pregnancy with micro-invasive carcinoma can be safely carried through to 24 weeks. The logic of picking 24 weeks, though based on viability, is one which many practising obstetricians would question. Surely if one can carry the pregnancy safely from 12 to 24 weeks one could carry it a further 4 weeks to 28 weeks when the shift in neonatal morbidity and mortality is significantly altered.
Occasionally there are lapses in the stems; Paper 2, question 206 suggests that ultrasound, CA125, and genetics are beneficial screening tools. To date, no randomised controlled trial clearly demonstrates that any of these methodologies are beneficial. Two randomised screening trials are currently underway. Some questions such as the one on the ‘confused geneticist’ are in themselves confusing and difficult to follow and would benefit from re-writing in a less ambiguous fashion. The use of eponymous terms such as YUZPE, is to be eschewed. The essence of a question should not be obfuscation.
All in all the book is well referenced, easy to read, with sensible evidence-based justifications for the majority of statements. It will be of interest to nascent gynaecologists.