Case Files Obstetrics and Gynecology, sixth edition, is dedicated to Jane Guerrero, RN, who has made a significant contribution to the health and safety of pregnant and postpartum women. Ms. Guerrero has had a nursing career that spanned more than 20 years in Texas acute care hospitals prior to her 20 years of service in public health at the Texas Department of State Health Services (DSHS). While at DSHS, she served 10 years as the director of the Office of EMS and Trauma Systems. The responsibilities of this office included ensuring hospital compliance with established Texas Administrative Code for trauma and stroke care, awarding trauma and stroke designation to Texas hospitals, and managing emergency medical services (EMS) licensing and compliance; this included approximately 290 designated trauma hospitals, 135 designated stroke hospitals, 65,000 licensed EMS professionals, 1100 EMS provider organizations, and EMS education programs.

Reproduced with permission, from Jane Guerrero, RN.

In 2013, the Texas Perinatal Levels of Care were developed through legislative efforts and enacted through the collaboration of the Executive Commissioner–appointed Perinatal Advisory Council (PAC), stakeholders, currently practicing professionals within the field, multiple professional organizations, and DSHS. The resulting requirements included two designation programs, neonatal and maternal levels of care for patients at lower risk, moderate risk, and high risk.

I am honored to call Ms. Guerrero a friend and colleague. I applaud her wisdom in guiding our perinatal designation process to be part of the existing hospital regional advisory councils, acting as an ambassador for both neonatal and maternal stakeholders and the regional advisory councils. She served as one of the key leaders in shaping our perinatal designation system. Without her extraordinary insight and direction, our efforts would likely have failed. With her steady hand, our neonatal and maternal designation systems have flourished and succeeded. She has been a pure and brilliant guiding light for us, and her mark on Texas will shine long into the future, lifting up countless pregnant women and newborns.

Eugene C. Toy

To my dear friend and colleague Jane G. Guerrero, RN, who served in the role as director of the Office of EMS/Trauma Systems of the Texas Department of State Health Services. She has been a brilliant chief architect for our maternal and neonatal levels of care designation in Texas, matching the patient severity of illness with the hospital capability. She displayed the rare combination of intellect, wisdom, compassion, humor, and dogged pursuit of what was the best for patients up through her retirement. Her contributions elevated the quality of care in Texas. The women and newborns of the Lone Star State are indebted to her.

—ECT

To Dr. James Knight, and Tulane Medical School, for giving me the opportunity to fulfill my dreams. To my parents, Mary and Jimmy Ross, for their love, inspiration, and devotion.

—PJR

Finally, to the wonderful medical students from the McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), who graciously gave constructive feedback and enthusiastically received this curriculum.

—THE AUTHORS