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Preterm Birth (The Mother (Postnatal care for the mother (• Complete…

- - - - The delivery of the placenta
        
        dramatic reduction in progesterone, estrogen, and human placental lactogen levels
    - - Colostrum is the first milk a breastfed baby receives.
      - contains higher amounts of white blood cells and antibodies than mature milk and is especially high in immunoglobulin A.
    - - Lactation is under endocrine control. The two main hormones involved are prolactin and oxytocin.
  - - - measure your uterus to check your baby’s growth
        
        listen to your baby’s heartbeat
        
        feel your abdomen to check the baby’s position
        
        due date
    - - a blood test
        
        anemia
        
        Rh test
        
        heart, lungs and blood pressure check
        
        a urine test
        
        Pap smear test
        
        a breast check
        
        an ultrasound, to confirm dates of pregnancy
  - - - Investigations
        
        Uterine monitoring
        
        measure the duration and spacing of your contractions.
        
        Ultrasound
        
        transvaginal ultrasound might be used to measure the length of your cervix
        
        confirm the baby's position, assess the volume of amniotic fluid, and estimate the baby's weight.
        
        Lab tests.
        
        swab of vaginal secretions to check for the presence of certain infections and fetal fibronectin
        
        urine sample in case of suspected UTI
      - Physical exam
        
        Pelvic exam
        
        determine whether your cervix has begun to open
        
        check for uterine bleeding
        
        evaluate the firmness and tenderness of your uterus and the baby's size and position
    - - Corticosteroids.
      - Magnesium sulfate
        
        reduce the risk of cerebral palsy for babies born before 32 weeks of gestation.
      - Tocolytics
        
        stops contractions
  - - - Early Labor Phase –The time of the onset of labor until the cervix is dilated to 3 cm.
      - Active Labor Phase – Continues from 3 cm. until the cervix is dilated to 7 cm.
      - Transition Phase – Continues from 7 cm. until the cervix is fully dilated to 10 cm.
    - - The period after the cervix is dilated to 10 cm until the baby is delivered.
    - - Delivery of the placenta.
  - - - Gestational Age by LMP is calculated from the first day of the last menstrual period.
      - EDD by LMP is calculated by adding 280 days (40 weeks) to the first day of the last menstrual period.
      - Gestational Age by US is measured by ultrasound (US) on the Ultrasound Date.
      - EDD by US is the estimated date of delivery based on the Gestational Age by US and the Ultrasound Date.
- - - - Scores 7 and above are generally normal
      - 4 to 6: fairly low
      - 3 and below: critically low.
  - - - Premature (less than 37 weeks gestation)
        
        causes
        
        Infection
        
        Poor nutrition right before or during pregnancy
        
        placenta previa
        
        History of preterm delivery
        
        Birth defects of the uterus
        
        cervical incompetence
        
        Prognosis
        
        possible complications
        
        Delayed growth and development
        
        Mental or physical disability or delay
        
        bronchopulmonary dysplasia
        
        retinopathy of prematurity
        
        The more premature an infant and the smaller the birth weight, the greater the risk for complications.
        
        medical, developmental, or behavioral problems that continue into childhood or are permanent.
        
        Examinations
        
        blood tests
        
        Blood tests to check glucose, calcium, and bilirubin levels
        
        Continuous cardiorespiratory monitoring
        
        Blood gas analysis to check oxygen levels in the blood
        
        indications
        
        Body hair (lanugo)
        
        Enlarged clitoris (in female infants)
        
        Less body fat
        
        Lower muscle tone and less activity than full-term infants
        
        Thin, smooth, shiny skin that is often transparent
        
        trouble sucking or coordinating swallowing and breathing
        
        Soft, flexible ear cartilage
        
        Physical examination
        
        anemia
        
        Bleeding into the brain or damage to the brain's white matter
        
        neonatal sepsis
        
        hypoglycemia
        
        Neonatal respiratory distress syndrome
        
        Jaundice
        
        patent ductus arteriosus
        
        necrotizing enterocolitis
        
        Risk factors
        
        Age (mothers who are younger than 16 or older than 35)
        
        Being African American
        
        Lack of prenatal care
        
        Low socioeconomic status
        
        Use of tobacco, cocaine, or amphetamines
        
        PTSD
      - Full term (37 to 42 weeks gestation)
      - Post term (born after 42 weeks gestation)
  - - - • Counsel on danger signs and home care
      - • Refer for routine immunisations
      - • Encourage and facilitate birth registration
      - opioid analgesics