Book reviews 41

lowing contraceptive steroids in primigravidae than

for the whole group. Also, the pathology is the same

in both groups. In this respect also Haller’s prospec-

tive study is interesting. Haller concluded from 3588

patients of which 377 were treated with hormones

during their pregnancy and 3211 who were not

treated with hormones; there was no statistical differ-

ence in the number of congenital malformations in

both groups. In conclusion, this book is recommended to

doctors interested in hormonal contraception.

A .A. Haspels, Utrecht

Pentozocin - ein neuer Weg

G.A. Neuhaus (ed.)

Georg Thieme Verlag, Stuttgart, 1975

(v + 86 pp., 18 Figs., 11 Tables)

DM 12.-

Pentazocin (Fortral) - a new way is a review of

the literature on this topic. This review shows the

old way: clinical research, and the new one: funda- mental research.

Kubicki presents aspects of modern neurophysiol-

ogical research. Beyer gives a summary of the clinical

analysis and the biotransformation. Missing in this

‘new way’, as mentioned in the discussion on page 23,

is a clear pharmacokinetic and pharmacodynamic study.

This booklet gives information on the clinical use-

fulness of pentazocin as an analgetic and narcotic antagonist.

G. Nijhuis, Nijmegen

Th I I65a (Par&s&en) bei der Behandlung in der Geburtshilfe und Perinatologie

H. Jung and F.K. Klock (eds.)

Georg Thieme Verlag, Stuttgart, 1975

(xv t 205 pp., 154 Figs., 50 Tables)

DM 49.-

This volume contains the Proceedings of a sympo- sium on the beta-adrenergic drug Th 1165a and its

applications in obstetrics. Contributions are given on

pharmacology, animal experiments and clinical prac-

tice. The design of the symposium - lectures mainly

on one drug - is one-sided. There are, however, some

contributions about other beta-adrenergic drugs and

some authors give comparisons between the different

preparations. In the experimental parts many inter- esting data but even more unsolved problems are re-

ferred to. The placental barrier in sheep may be

passed by the beta-adrenergic drug ritodrine, but about Th 1165a in man no definitive conclusions could be drawn. Experiments in Rhesus monkeys sug-

gest that Th 1165a could have a negative influence on

the condition of the fetus possibly by a reduction of uteroplacental circulation. Experiments with the

angiographically visualized uteroplacental circulation

in the same animal, however, give the impression that

the uteroplacental circulation increases during beta-

adrenergic treatment.

Conclusions on the clinical effects of beta-adrener-

gic drugs are even more difficult. The influence on

uterine activity in individual cases is generally known,

the main indication being threatening premature labor. In spite of general application of these drugs

several clinical reports in this volume cannot confirm

a drop in the incidence of prematurity. The difficul-

ties in assessing the effect of treatment are caused

partly by the lack of objective methods to ascertain

the diagnosis ‘threatening premature labor’. There is

still a need for controlled trials to determine the real

clinical effects of treatment; this book gives clear evidence of this need, in spite of some enthusiastic

but not completely convincing clinical reports. Treat- ment of threatening abortion with Th 1165a is re-

ported and recommended but needs critical appraisal, especially from a statistical point of view.

This book is a source of facts and research reports

on the subject. It raises interesting questions and can be recommended for critical reading to research

workers, pharmacologists and clinicians.

P.E. Treffers, Amsterdam