Preterm birth is one of the more frequent complications of pregnancy yet it remains an enigma to the clinician. Preterm labor is difficult to diagnose, and there is no clearly effective treatment. The consequence of preterm labor-delivery of a premature infant-accounts for significant neonatal morbidity. Despite numerous publications and investigations, there has been little change in the rate of preterm birth.
In this issue of The Journal of Perinatal & Neonatal Nursing (16:1), Abrahams and Katz offer an explanation why research findings have been difficult to apply to clinical practice. They discuss a perspective of the etiology of preterm labor and review methods for diagnosis.
Assessment of fetal status is an important aspect of care during preterm labor. McMurtry Baird and Ruth describe differences in the preterm versus the term fetus and the impact these differences have on fetal surveillance.
Witcher reviews pharmacologic and nonpharmacologic treatment of preterm labor. She discusses conventional measures and tocolytic therapy aimed at prolonging the pregnancy. Goering and Wilson describe one hospital's efforts to improve care to this group of patients using collaborative practice guidelines.
The musculoskeletal system of the preterm infant in an intensive or special care nursery is still undergoing significant maturation.
Multidisciplinary strategies are suggested. Sweeney and Gutierrez describe these maturational processes and the implications for positioning of preterm infants in the neonatal intensive and special care nurseries. They note how the plasticity of the musculoskeletal system in these infants can be used constructively to not only foster alignment and symmetrical shaping, but also demonstrate the potential for adverse consequences from inappropriate positioning. The critical role of the nurse in enhancing musculoskeletal maturation and preventing later deficits is emphasized.
The final article in this issue describes an approach to facilitating parenting of preterm infants within the neonatal intensive care unit. Lawhon describes her exploratory study to evaluate an individualized nursing intervention based on assumptions of parental and infant competence. The study focuses on the process of evaluating the effectiveness of an individualized intervention and the issues that were generated. Implications for both further research and current clinical practice are discussed.