An early arrival

An early arrival

1. Antenatal care

   • Check for pre-eclampsia
   • Check for anaemia
   • Check for syphilis
   • Give preventive measures
   • Develop a birth and emergency plan
     • In case one of the risk factors like placenta previa
   • Advise and counsel on family planning
   • Check for HIV status

2. Stages of labour

   • Three stages of labour

3. Investigations

   • Normal postpartum changes
     • Low‑grade fever, shivering, and leukocytosis are common findings during the first 24 hours
     • Uterine involution
       • uterus returns to its normal size by the 6th–8th week postpartum
   • Clinical features of preterm birth
     • Regular uterine contractions and associated symptoms of labor
     • Cervical dilation ≥ 3 cm, effacement, or both
     • Premature rupture of membranes
   • Fetal presentation
   • PV examination
   • Abdominal examination
   • Auscultation (Doppler's)

4. Risk factors of premature birth

   • previous premature birth
   • Pregnancy with twins, triplets or other multiples
   • IVF
   • Problems with the uterus, cervix or placenta
   • Smoking cigarettes or using illicit drugs
   • infections

5. Complications of premature birth

   • Breathing problems: lack surfactant , may develop respiratory distress syndrome
   • Heart problems: patent ductus arteriosus (PDA) and low blood pressure (hypotension)
   • Brain problems: risk of bleeding in the brain, known as intraventricular hemorrhage that may cause permanent brain injury
   • Behavioral and psychological problems

6. Apgar Score

   • First examination done

7. Examination of a newborn

   • Body temperature
   • gestational age, size, and weight
   • Weight and length
   • Heart and lungs
   • Eyes and ears, mouth
   • Spine
   • Arms and legs
   • Abdomen and anus

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