1. Angelini, Diane J. EdD, CNM, FACNM, FAAN, Journal Editors
  2. Blackburn, Susan PhD, RN,C, FAAN, Journal Editors

Article Content

In the 18:2 "Selected Topics" issue for the perinatal section of JPNN, 4 articles are featured. One involves a clinical topic of fertility assessment and preconception, another focuses on risk management assessment, ie, reviewing the Emergency Medical Treatment and Labor Act (EMTALA) law and two manuscripts focus on research issues: one is a pilot study involving a clinical topic and the other an economic analysis on return on investment for a prenatal program at a managed care organization.


Barron discusses fertility assessment and preconception issues. She reviews gynecologic charting typically used in natural family planning situations and in charting menstrual cycle abnormalities.


Porter, Lookinland, and Belfort present pilot data on 20 women with idiopathic polyhydramnios and/or macrosomia without gestational diabetes mellitus and compare them to 20 pregnant women with a normal ultrasound. They attempted to assess realtime blood glucose concentration in women with idiopathic macrosomia and/or polyhydramnios but with a normal baseline glucose screen to a group of controls. Their findings present baseline data for a larger study focusing on blood glucose levels and complications in euglycemic women and those with impaired glucose tolerance.


Glass et al explore the federal EMTALA, which is one of the most difficult laws to interpret and one that has such relevance for perinatal providers. She provides a basic overview with selected cases as well as risk reduction strategies to help avoid common pitfalls.


An economic analysis of a prenatal program at a managed care organization is presented by Sackett et al. They evaluated the cost/benefit of a prenatal program for low and very low birth weight infants. They showed a positive return on investment using economic analyses only in assessing this program.


The neonatal section of this issue includes 3 research-focused articles and 1 on a clinical topic. The birth of an infant with a congenital anomaly has a significant impact on family members and may jeopardize their ability to adapt. Pelchat, Lefebvre, Proulx, and Reidy have been involved in a family intervention program to provide education and support based on joint nurse-family partnerships. Their article describes an evaluation of parental satisfaction with this program by families with newborns with 2 types of health problems: cleft lip and palate and Down syndrome. Parents were surveyed regarding their satisfaction with the program in relation to helping with their individual response, marital communication, communications with extended family and friends, and printed material distributed to the parents during the intervention sessions.


Two articles address topics related to infant feeding. Chertok, Shoham-Vardi, and Hallak examined the use of a culturally appropriate breastfeeding intervention to increase breastfeeding initiation and duration rates among postcesarean Jewish and Muslim women in Israel. Their intervention included early maternal-infant contact and breastfeeding support and education. A highlight of this article is the discussion of cultural aspects of breastfeeding from the perspective of the Muslim tradition and the Jewish tradition. In addition cultural aspects of breastfeeding from the 2 largest immigrant Jewish subgroups, Ethiopian and Russian, are also discussed.


Feeding is a major concern for both parents and staff in the neonatal intensive care unit and for at least the first year after hospital discharge. Few studies have explored the meaning of these concerns to parents. Pridham, Saxe, and Limbo describe a framework that can be used to explore feeding concerns with parents and evaluate progress in addressing feeding issues. They use 3 case studies to illustrate application of this framework by nurses. The major concerns of the mothers described in the case studies related to the amount or adequacy of their infant's feeding. The authors discuss how the mother's working model of parenting can be used in to help understand feeding issues from the parent's perspective.


Decisions regarding whether or not to transfuse preterm infants are often difficult and compounded by a lack of evidence-based studies to guide practice. Bain and Blackburn examine issues related to red blood cell transfusions for preterm infants in the neonatal intensive care unit. They focus on the physiologic basis for anemia in preterm infants, clinical consequences of anemia, issues about when to transfuse, benefits and risks of red blood cell transfusions, the role of erythropoietin therapy, and implications for nursing care.