For the fourth edition, Dr Queenan has replaced up to a third of the 96 contributors to get some "new blood" into the book. He has invited more contributions from European authors in order to better cater to an international readership. The book does, however, retain the popular "protocols" theme, in which very brief chapters on the spectrum of HRP topics provide quick summaries of a problem and diagnostic and therapeutic steps to manage it. Every chapter has been revised carefully to reflect the latest thinking on the best approach to pregnant patients with risks like tuberculosis, STDs, bleeding, pre-eclampsia, etc. The many quick reference tables and charts are updated as, are the brief bibliographies accompanying each chapter.

This new edition provides increased coverage of IUGR, Pre-eclampsia, teratology and genetics. New chapters have been introduced on doppler ultrasound, nuchal translucency and also on AIDS in pregnancy.

Furthermore this fourth edition is evidence-based. The new editor, Catherine Spong, is a guru of evidence-based medicine and as well as one of the editors of the journal of the American College of Obstetricians and Gynecologists: Obstetrics and Gynaecology, directs the foetal medicine programme at the National Institute of Health in Washington.