Medication Safety in Pregnancy and Breastfeeding. By Gideon Koren, MD. Whitby, ON: McGraw-Hill Ryerson, 2007. ISBN 0071448284, 9780071448284, 623 pages. $121.95. 

This valuable reference book, edit­ed by the director of the renowned Motherisk Program at Toronto’s Hospital for Sick Children, comes in two parts. Part 1 comprises 23 chapters on topics in maternal fetal toxicology, while part 2 comprises MASTER (the Motherisk Archives of Systematic and Evaluative Reviews), which includes previously published systematic re­views covering methodologic aspects, maternal morbidities, alcohol, caffeine, cocaine, and environmental ex­posure, and maternal use of vitamins, contraceptives, and therapeutic drugs. 

It would be difficult to imagine a more comprehensive or useful re­source in this area, apart from setting the entire Motherisk team to work to answer your own specific clinical concern. I tried to think of bizarre and outrageous exposures to potential toxins that a pregnant woman might des­cribe, but could not come up with anything that has not been covered here. Even microwave ovens (around them, not in them) and alfalfa have been considered and the risks from exposure thoughtfully dissected. 

Anyone providing care for pregnant women really should keep a copy of this book close by. By the time you have sifted through the answers that Google might give you, this book will have provided the information you seek and be waiting for more challenges. It’s a very impressive collection.