Maternal, Fetal, & Neonatal Physiology: A Clinical Perspective, 5e

Book Preface

Accurate assessment and clinical care appropriate to the de-velopmental and maturational stage of the mother, fetus, and neonate depend on a thorough understanding of normal physiologic processes and the ability of the caregiver to under-stand the effects of these processes on pathologic alterations. Information on normal pregnancy and perinatal physiology and its clinical implications can be found in various sources. These sources are often either fragmented, too basic in level, too focused on one phase of the perinatal period (and thus lacking integration within the maternal-fetal-neonatal unit), or lacking in the clinical applications relevant to patient care. Thus they do not adequately meet the needs of nurses in specialty and advanced clinical nursing practice.

Therefore the goal of the first and subsequent editions of this book was to create a single text that brought together detailed information on the physiologic changes that occur throughout pregnancy and the perinatal period, with empha-sis on the mother, fetus, and neonate and the interrelation-ships among them. Maturational changes during infancy, childhood, and adolescence are also discussed. The purpose of this book is not to provide a manual of specific assessment and intervention strategies or to focus on pathophysiology—it is to present current information on the normal physiologic adaptations and developmental physiology that provides the scientific basis and rationale underlying assessment and management of the low-risk and high-risk pregnant woman, fetus, and neonate. Because the focus of this book is on physiologic adaptations, the psychological aspects of perina-tal and neonatal nursing are not addressed. These aspects are certainly equally as important but are not within the realm of this text.

This book provides detailed descriptions of the physiologic processes associated with pregnancy and with the fetus and neonate. The major focus is on the normal physiologic adaptations of the pregnant woman during the antepartum, intrapartum, and postpartum periods; anatomic and func-tional development of the fetus; transition and adaptation of the infant at birth; developmental physiology of the neonate (term and preterm); and a summary of the maturation of each body system from infancy to adolescence. Clinical implica-tions of these physiologic adaptations as they relate to the pregnant woman, maternal-fetal unit, and neonate are also examined. Each chapter describes the effects of normal physi-ologic adaptations on clinical assessment and interventions with low-risk and high-risk women and neonates with se-lected health problems. Of special interest to those seeking quick access to clinical information are boxes with recom-mendations for clinical practice that are included in each chapter, referencing pages with relevant content that provides the rationale underlying each recommendation. New to this edition is an appendix with definitions of abbreviations fre-quently used in the text.

Advanced practice nursing must be based on a sound physiologic base. Thus I hope that this book will be a useful foundation reference for specialty and advanced practice nurses in both primary and acute care settings, as well as for graduate programs in maternal, perinatal, and neonatal nurs-ing and nurse midwifery. This book may also hold appeal for other health care professionals including physicians; physical, occupational, speech, and respiratory therapists; and nutri-tionists involved in obstetrics and neonatology.

ACKNOWLEDGMENTS

The help and support of many individuals were critical in making this book a reality. These include former and current students, nursing staff, and colleagues who stimulated me to continue to expand my knowledge of perinatal and neonatal physiology and examine the scientific basis for nursing inter-ventions with pregnant women and neonates. The women, neonates, and their families for whom I have cared and from whom I have learned a great deal also stimulated develop-ment of this book. Thank you to Ilana Azulay Chertok, Robin Webb Corbett, Georgia Ditzenberger, Tekoa King, and Jacqueline Wolf for sharing their expertise in the chapters they contributed to this edition. Special thanks to Susan Skinner and Elizabeth Posey for their assistance with manuscript preparation. I am grateful for the efforts of the reviewers, whose constructive comments and suggestions helped in re-fining the content and in making this book more useful for the intended audience. My appreciation and thanks also goes to the staff at Elsevier, particularly Laurel Shea, Associate Content Development Specialist, and Anne Konopka, Senior Project Manager, for their assistance in the development and production of this book. Finally I would like to thank my family for their support, guidance, and encouragement in all of my endeavors.

Susan Tucker Blackburn