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Care of The Mother and Fetus During The Perinatal Period
Care of The Mother and Fetus During The Perinatal Period
Care of The Mother and Fetus During The Perinatal Period
products of conception.
MOTHER AND FETUS DURING
Lochia – Discharge from the uterus that consists
THE PERINATAL PERIOD: of blood from the vessels of the placental site
and debris from the decidua; lasts for 2 to 3
weeks after delivery
Ballottement – Rebounding of the fetus against Newborn – A human offspring from the time of
the examiner’s finger on palpitation. When the birth to the twenty-eighth day of life; also
examiner taps the cervix, the fetus floats called neonate
upward in the amniotic fluid. The examiner
feels a rebound when the fetus falls back. Parity – the number of pregnancies that have been
carried to viability
Chadwick’s sign – Bluish coloration of the
mucuous membranes of the cervix, vagina , and Placenta – the organ that provides for the
vulva that occurs at about 6 weeks of pregnancy exchange of nutrients and waste products
and is a probable sign of pregnancy. between the fetus and the mother, produces
hormones to maintain pregnancy, and develops
by the third month of gestation; also called
Delivery – is Actual event of birth; the expulsion afterbirth.
or extraction of the neonate.
Quickening – First perception of fetal movement,
Fertilization – Uniting of the sperm and ovum, appearing usually in the sixteenth to eighteenth
which occurs within 12 hours of ovulation and week of pregnancy.
within 2 to 3 days of insemination, the average
duration of viability for the ovum and sperm.
Cervix - is the internal os that opens into the body - Most follicles die, leaving one to mature into a
of the uterine cavity. Cervical canal is located large GRAAFIAN FOLLICLE.
between the internal os and the external os.
External cervical os opens into the vagina. - Estrogen produced by the follicle stimulates
increased secretions of luteinizing
Vagina - mucous membrane-lined channel through hormone(LH) by the anterior lobe of the
the muscles of the pelvic floor, known as the pituitary gland.
Birth canal. It is the passageway between the
cervical os and the external environment 2. Luteal phase
(passageway for menstrual blood flow and
- The luteal phase begins with ovulation.
passageway for fetus).
(ovulation typically occurs at mid- point of the
menstrual cycle).
2. Luteal phase
- Ovulation occurs between day 12 and 16 of the Pelvic inflammatory disease (PID)
menstrual cycle. Uterine fibroids
Abnormal pregnancy (miscarriage, ectopic)
- Estrogen is high and progesterone is low. Infection, tumors, or polyps in the pelvic cavity
3. Android
a. wedge-shaped or angulated
b. seen in males
c. not favorable for labor
d. narrow pelvic planes can cause slow descent FERTILIZATION and IMPLANTATION
and midpelvis arrest.
A. Fertilization
4. Platypelloid
1. occurs in the upper region of the fallopian
a. flat with an oval inlet. tubes.
b. wide transverse diameter but short 2. occurs within 12 hours after ovulation and
anteroposterior diameter, making the outlet within 2 to 3 days of insemination, the average
inadequate. duration of viability for the ovum and the
sperm.
This type of twin formation begins >Groove forms along middle of back.
when one sperm fertilizes one
>Blood circulation begins.
egg (oocyte). 1 As the fertilized egg
(called a zygote) travels to the uterus, >Heart is tubular
the cells divide and grow into a
blastocyst. In the case of monozygotic
twins, the blastocyst then splits and
develops into two embryos. Week 5-8
A. Preembryonic period: the first 2 weeks after > Eyelids begins to fuse.
conception. > Circulatory system through umbilical cord is well
B. Embryonic period; beginning of the third week established.
through the eighth week after conception.
After the eight week the baby is called a fetus The reproductive organs and genitalia are now fully
instead of an embryo. developed,
Week 17-20
>Fetus is 8 cm in length.
>Fetus is 45 g.
>Limbs are long and slender. >Lanugo covers the entire body.
Fetus is 28 cm in length.
Fetus 780 g.
• Your baby's heartbeat may now be audible
through an instrument called a doppler. Hair on head well formed.
Skin is reddish and wrinkled.
• The fingers and toes are well-defined.
Reflex hand grasp functions.
• Eyelids, eyebrows, eyelashes, nails and hair are Vernix caseosa covers entire body.
formed.
Fetus has ability to hear.
• Teeth and bones become denser. • Baby's finger and toe prints are visible.
• Your baby can even suck his or her thumb, • In this stage, the eyelids begin to part and the
yawn, stretch and make faces. eyes open.
Week 25-28
Fetus is 38 cm length.
Fetus is 1200 g.
Eyelids open and close. The skin is pink and the body is rounded.
Lungs are developed sufficiently to provide The skin is less wrinkled.
gas exchange (lecithin forming) lecithin
forming for lung development components Lanugo is disappearing.
are phosphatidylcholine and • During this stage, your baby will continue to
phosphatidylglycerol, capable of gas grow and mature.
exchange in the last trimester. Exchanging
• The lungs are close to being fully developed at
portion of the lungs is formed and
this point.
vascularized.
If born, neonate can breathe at this time. • Your baby's reflexes are coordinated so he or
she can blink, close the eyes, turn the head,
Week 29-32 grasp firmly, and respond to sounds, light, and
touch.
Week 37-40
fetus is 40 cm in length.
Fetus is 2000 g.
1. The chorion is the outer membrane. 1. The umbilical cord contains two arteries and
one vein.
2. The chorion becomes vascularized and forms
the fetal of the placenta. 2. Arteries carries deoxygenated blood and waste
products from the fetus.
c. Amniotic Fluid
3. The veins carries oxygenated blood and
1. The amniotic fluid consists of 800 to 1200 mL provides oxygen and nutrients to the fetus.
by the end of pregnancy.
B. Fetal heart rate
2. the amniotic fluid surrounds, cushions, and
protects the fetus and allows for fetal 1. the fetal heart rate depends on gestational age;
movement. 160 to 170 beats per minute in the first trimester
but slows with fetal growth to 120 to 160 beats
3. The amniotic fluid maintains the body per minute near or at term.
temperature of the fetus.
2. the fetal heart rate is about twice the maternal
4. the amniotic fluid consists largely of the fetal heart rate.
urine and is therefore a measure of fetal kidney
function. C. Fetal circulation bypass
5. The fetus drinks, swallows, and urinates the 1. is present because of nonfunctioning lungs.
amniotic fluid and breathes the amniotic fluid
2. bypasses must close following birth to allow
into its lungs.
blood to flow through the lungs and the liver.
d. Placenta 3. ductus arteriosus connects the pulmonary
artery to the oarta, bypassing the lungs.
4. ductus venosus connects the umbilical veins 3. Primigravida is a woman who has had one birth
and the inferior vena cava, bypassing the liver. that occurs after the twenthieth week of
gestation.
5. foramen ovale in the opening between the right
and left atriums of heart, bypassing the lungs. 4. Multipara is a woman who has had two or more
pregnancies resulting in viable offspring.
OBSTETRICAL ASSESSMENT:
Use of GTPAL:
GESTATION
1. G is gravidity, the number of pregnancies.
a. Time until the estimated date of confinement or
estimated date of delivery. 2. T is term births, the number born at term
(40weeks).
b. About 280 days.
3. P is preterm births, the number born before 40
c. Nagele’s rule for estimating the date of
weeks of gestation.
confinement. For Nagele’s rule to be accurate
requires that the woman have a regular 28-day 4. A is abortions/miscarriages, the number of
menstrual cycle. abortions/miscarriages (included in gravida if
before 20 weeks of gestation; included in parity
1. First day of the last menstrual period: 09/11/2006
if past 20 weeks of gestation.
2. Add 7 days: 09/18/2006
5. L is live births, the number of live births or living
3. Subtract 3 months: 06/18/2006 children.
T- term births
A- abortions/miscarriages
A. Gravity
L- live births
1. Gravida refers to a pregnant woman.
EXAMPLE: A woman is pregnant for the fourth
2. Gravidity refers to the number of pregnancies.
time. She had one elective abortion in the first
3. Nulligravida is a woman who has never been trimester, a daughter who was born ar 40 weeks
pregnant. of gestation, and a son who was born at 36
weeks of gestation. Therfore she is gravida (G)
4. Primigravida is a woman who is pregnant for the 4, parity 2, and term (T) 1 (the daughter born at
first time. 40 weeks); preterm (P) 1 (the son born at 36
weeks); abortion (A) 1 (the abortion is counted
5. Multigravida is a woman in at least her second
in the gravidabut is not included in the para
pregnancy.
because it occurred before 20 weeks); live
B. Parity births (L) 2.
B. Probable signs
A. Presumptive signs b. During the second and third trimesters (weeks
18 to 30), fundal height in centimeters
1. amenorrhea approximately equals the fetus’s age in weeks
plus or minus 2 cm.
2. nausea and vomiting
c. At 16 weeks, the fundus can be found halfway
3. increased size and increased feeding of
between the symphysis pubis and the umbilicus.
fullness in breasts
d. At 20 to 22 weeks, the fundus is at the
4. pronounced nipples
umbilicus.
5. urinary frequency
e. At 36 weeks, the fundus is at the xiphoid
6. Quickening: the first perception of fetal process.
movement may occur as early as the fourteenth
to sixteenth week of gestation.
B. Probable signs 2. Place the end of the tape measure at the level of
the symphysis pubis.
1. uterine enlargement
3. Stretch the tape to the top of the uterine fundus.
2. Hegar’s sign: softening and thinning of the
4. Note and record the measurement.
lower uterine segment that occurs about week 6
1. fetal heart rate detected by electronic device 2. Maternal infection during the first 8 weeks of
(DOPPLER transducer) at 10 to 12 weeks and gestation carries the highest rate of maternal
by nonelectronic device (Fetoscope) and fetal infection.
3. outline of fetus via radiography or ultrasound. a. Infection may cross the placenta.
3. substances abuse threatens normal fetal growth 2. Physiological anemia occurs as the plasma
and successful term completion of the increase exceeds the increase in red blood cell
pregnancy. production.
4. Substance abuse places the pregnancy at risk for 3. Iron requirements are increased.
fetal growth retardation, abruptio placentae, and
4. Heart size increases and is elevated upward
fetal bradycardia.
and to the left because of displacement of the
5. Physical signs of drugs abuse may include dilated diaphragm as the uterus enlarges
or contracted pupils, fatigue, tracks (needle)
5. pulse may increase about 10 beats per
marks, skin abscesses, inflamed nasal mucosa,
minute.
and inappropriate behavior by the mother.
6. Blood pressure may decline in the second
6. Consumption of alcohol during pregnancy may
trimester.
lead to fetal alcohol syndrome and can cause
jitteriness, physical abnormalities, congenital 7. Retention of sodium and water may occur.
anomalies, and growth deficits.
B. Respiratory System
7. Smoking leads to low birth weights, a higher
incidence of birth defects, and stillbirths. 1. Oxygen consumption increases by 15% to
20%.
E. ADOLESCENT PREGNANCY
2. Diaphragm is elevated because of the enlarged
1. factors that result in adolescent pregnancy uterus.
include the early onset of menarche, changing
sexual behaviors in this age group, problems 3. Respiratory rate remains unchanged.
4. A woman may experience shortness of breath. a. Uterus enlarges, increasing in mass from 60
g to 1000 g.
7. Gum tissue become swollen and easily bleed. a. Hypertrophy and thickening of the muscles
occurs
8. Ptyalism (excessive secretion of saliva) may
occur. b. Increase in vaginal secretions is experienced,
and secretions are usually thick, white and
D. Renal System acidic.
1. Frequency of urination occurs in the first 5. Breasts
and third trimesters as a result of pressure of
the enlarging uterus on the bladder a. Breasts size increases.
2. Decreased bladder tone may occur and is b. Nipple become more pronounced.
caused by hormonal changes.
c. Areola becomes darker in color.
3. Decreased bladder capacity is experienced.
d. Superficial veins become prominent.
4. Renal threshold for glucose may be reduced.
e. Hypertrophy of the Montgomery’s follicles
E. Endocrine System occurs.
1. Basal metabolic rate rises. f. Colostrum may appear from the breasts.
3. Thyroid enlarges slightly, and thyroid activity 1. Pigmentation increases. It is believed that
increases. higher levels of estrogen and progesterone, and
melanocyte-stimulating hormone cause this
4. Parathyroid increases in size. skin darkening.
5. Aldosterone levels gradually increase. 2. A dark steak down the midline of the abdomen
may appear (linea nigra).
2. Body weight increases. 4. Finally, the woman prepares realistically for the
birth and parenting of the child.
3. Water retention is increased, which can
contribute to weight gain.
Discomforts of Pregnancy
A. Nausea and Vomiting I. Ankle edema
2. Psychological Maternal Changes
B. Syncope J. Varicose veins
A. Ambivalence D. Body Image Changes
C. Urinary urgency and frequency K. Headaches
B. Acceptance E. Relationship with the fetus
D. Breast tenderness L. Hemorrhoids
C. Emotional Lability
E. Increased vaginal discharge M. Constipation
3. Father may experience ambivalence related to 1. Nausea and vomiting occur in the first
the new role he is assuming, the increased trimester.
financial responsibilities, and sharing the wife’s
2. Nausea and vomiting are due to elevated
attention with the child.
levels of human chorionic gonadotropin and
B. Acceptance: Factors that may be related to changes in carbohydrate metabolism.
acceptance of the pregnancy are the woman’s
Interventions:
readiness for the experience and her identification
with the motherhood role. a. Eating dry crackers before arising
C. Emotional Lability b. Avoiding brushing teeth immediately after
arising.
1. Emotional lability may be manifested by
frequency in the change of emotional states or c. Eating small, frequent, low-fat meals during
extremes in emotional states.
the day.
2. These emotional changes are common, and
the mother may feel that these changes are d. Drinking liquids between meals rather than
abnormal. at meals
e .Avoiding fried foods and spicy foods. 1. Increased discharge can occur from the first
through the third trimester.
f. Acupressure (some type may require a
prescription). 2. Increased discharge is due to hyperplasia of
vaginal mucosa and increased mucus
g. Herbal remedies, only if approved by a production.
physician or nurse-midwife
Interventions:
B. Syncope
a. Proper cleansing and hygiene
1. Syncope usually occurs in the first trimester,
supine hypotension occurs particularly in the b. Wearing cotton underwear
second and third trimester
c. Avoiding douching
2. Syncope may be triggered hormonally or
d. Advising the client to consult the physician
caused by the increased blood volume, anemia,
or nurse-midwife if infection is suspected.
fatigue, sudden position changes, or lying
supine. F. Nasal stuffiness
Interventions: 1. Nasal stuffiness occurs during the first through
the third trimester
a. Sitting with the feet elevated
2. Nasal stuffiness results from increased
b. Changing positions slowly
estrogen, which causes swelling of the nasal
c. Changing the position to the lateral tissues and dryness
recumbent to relieve the pressure of the uterus
Interventions:
on the inferior vena cava\
a. Encouraging the use of a humidifier
C. Urinary urgency and frequency
b. avoiding the use of nasal sprays or
1. usually in the first and third trimesters
antihistamine
2. Due to pressure of the uterus on the bladder
G. Fatigue
Interventions:
1. Fatigue occurs usually in the first and third
a. Drinking 2 qt of fluid during the day trimesters
b. Limiting fluid intake in the evening 2. Fatigue usually results from hormonal
changes.
c. Voiding at regular intervals
Interventions:
d. Sleeping on the side at night
a. Arranging frequent rest periods throughout
e. Wearing perineal pads if necessary the day
1. Tenderness can occur from the first through d. Performing muscle relaxation and
the third trimesters strengthening exercises for the legs and hip
joints
2. Tenderness is due to increased levels of
estrogen and progesterone. e. Avoiding eating and drinking foods
containing stimulants throughout pregnancy
Interventions:
H. Heartburn
a. Encouraging wearing a supportive bra.
1. Heartburn occurs in the second and the third
b. Avoiding the use of soap on the nipples and
trimesters.
areola area to prevent drying.
2. Heartburn results from increased progesterone
E. Increased vaginal discharge levels, decreased gastrointestinal motility and
esophageal reflux, and displacement of the 2. Headaches result from changes in blood
stomach by the enlarging uterus. volume and vascular tone
Interventions: Interventions:
b. Sitting upright for 30 minutes following a b. Applying a cool cloth to the forehead
meal
c. Eating a small snack
c. Drinking milk between meals
d. Using acetaminophen (Tylenol) only if
d. Avoiding fatty and spicy food prescribed by the physician
2. Edema results from vasodilation, venous statis, a. Soaking in a warm sitz bath
and increased venous pressure below the uterus.
b. Sitting on a soft pillow
Interventions:
c. Eating high-fiber foods and avoiding
a. Elevating the legs at least twice a day. constipation
1. Varicose veins usually occur in the second and 1. Constipation usually occurs in the second and
the third trimesters. the third trimesters.
2. Varicose veins result from weakening walls of 2. Constipation result from decreased intestinal
the veins or valves and venous congestion. motility, the displacement of the intestines, and
taking of iron supplements.
Interventions:
Interventions:
a. Wearing support hose
a. Eating high-fiber foods
b. Elevating the feet when sitting
b. Drinking sufficient fluids
c. Lying with the feet and hips elevated
c. exercising regularly
d. Avoiding long periods of standing or sitting
d. Avoiding laxatives or enemas without first
e. Moving about while standing to improve consulting with the physician
circulation
N. Backache
f. Avoiding leg crossing
1. Backache usually occurs in the second and the
g. Avoiding constricting articles of clothing third trimesters.
1. Dyspnea can occur in the second and third 2. Screenings can detect spina bifida and Down
trimesters syndrome.
C. Chorionic villus sampling H. NONSTRESS TEST 2. Test is performed for the purpose of detecting
genetic abnormalities
D. Kick counts (fetal movement counting)
Interventions
E. Amniocentesis I. CONTRACTION STRESS TEST
a. Obtain informed consent.
INTRAPARTAL PERIOD:
I. CONTRACTION STRESS TEST THEORIES OF LABOR ONSET
Description A. UTERINE MYOMETRIAL IRRITABILITY (UTERINE STRECTH)
b. onset
c. signs of lightening
-. relief of dyspnea
2. PASSENGER.
This refers to the fetus and its ability to move fetal head diameters
through the passage way, which is based on the
following: A. anteroposterior (AP) diameters: wider than
the transverse diameters of the head
B. Transverse diameters
2. bitemporal diameter; 8 cm
3. bimastoid diameter; 7 cm
a. occiput (o)
b. mentum (m)
c. sacrum (s)
d. acromiodorso (ad)
-4 imaginary quadrants
a. left anterior
3. Fetal presentation
b. left posterior
-Cephalic
c. right anterior
a. vertex is the normal way that the baby is
positioned for birth. The baby is positioned d. right posterior
head first with their occiput ( the part of the
-Assessment of fetal position:
head close to the base the of skull) entering the
birth canal first.’ a. leopold’s manuever
b. vaginal examination
FETAL STATION
b. sinciput
c. brow
d. face
4. The Power
Characteristics:
Fetal station: +1
-Active Labor – this stage generally lasts 3-5 In the choice of position in labor, consider the
hours. Contractions are 45- 60 seconds long and following; maternal, physical and psychologic
3-5 minutes apart, cervix is 4-7 cm; complete needs, fetal well being.
effacement
Nursing intervention:
Causes of labor pain
@encourage slow and shallow breathing
1st stage of labor
@offer paper bag to breathe into(
hyperventilate->hyperventilation is main @primary source of pain- dilatation of the cervix
problem in this stage)
@Hypoxia of the uterine muscles during
@instruct woman to cupped hands and contraction
breathe into it.
@stretching of the lower uterine segment
Note: Hyperventilation may lead to respiratory
alkalosis. @pressure at the adjacent structures
Nursing intervention:
@ clean up vomitus
@provide backrub
1. Factors that make labor meaningful:(Clark and - Woman concentrates on forcing the abdominal
Alfonso, 1978) muscles to rise
a. Cultural influences integrating maternal - Use of slow abdominal breathing in the 1st stage
attitudes of labor: 1 breath/minute(30 seconds inhalation
and 30 sec. exhalation)
b. Expectations and goals for the labor
process - Use of panting to prevent pushing until needed.
b. support system
Bradley Method- partner or husband coached
- husband – can provide emotional natural childbirth
support ( lessen anxiety -> lessen emotional
tension->less pain perception. -uses relaxation and slow controlled breathing
- attending nurse-should provide a supporting - Basically same techniques as the ones used in read
and caring environment , respect the client’s/ method.
family’s needs and attitudes->provide
therapeutic communications
CARDINAL MECHANISM OF
LABOR:
Causes of Labor pain
Engagement
nd
2 stage
Descent
@hypoxia of contracting uterine muscles
Flexion
@distension of the vagina and perineum
Internal rotation
@pressure on adjacent structures
Extension
Restitution
NATURAL CHILDBIRTH: External rotation
Dick – read method: Expulsion
Lamaze method of psychoprophylaxis
Bradley Method
Second Stage
Perineum bulges
Nursing intervention:
Psychological support
Monitor FHT
2. Duncan’s mechanism
- the return of the uterus to its normal size after 1. Edematous after delivery. Inspect episiotomy
childbirth daily for normal healing; observe for redness,
edema, ecchymosis, discharge approximation
3 processes involved in involution (REEDA) , and hematoma.
d. Client should wear tight bra to compress -Immunologic properties help prevent infections
ducts & use cold applications to reduce
-Easily digested
swelling.
-Constipation unlikely
3. Extent upto 2 years – mother can continue breast Close to the mother’s body so the baby is
feeding the baby as long as she feels brought to the breast rather than the breast taken
comfortable to the baby
Baby is supported at the head, shoulders, and if o Some veins are bulging
newborn the whole body is supported
Edema
Baby is facing breast with the baby’s nose close
as possible to the nipple o Also water retention and swollen limbs
symphysis pubis
4. Inspection of lower extremities
- during pregnancy as much as 2000ml-3000ml
Varicosities (varicose veins)
excess fluid accumulates in the body
o Are swollen veins just below the skin caused by
• Urine output
the increase in blood during pregnancy resulting
from the increase of hormone progesterone, Check for bladder distention of unable to void
which also softens the tissues of the veins, and (risk for UTI)
the weight of the growing uterus putting
pressure on the veins to the legs and slowing the Apply warm compress on hypogastric area
flow of blood.
Difficulty of urination may be caused by
o Some have blue or purple spot traumatized urinary meatus during labor and
delivery
Full bladder displaces the uterus up and to the 3. Assess bladder. Birth trauma, anesthesia, and
side, resulting in uterine atony or inability of the pain from lacerations and episiotomy
uterus to contract and this is the primary cause
of excessive bleeding 4. Assess vital signs
2. Inspect perineum frequently for visible signs of 2. Sitz bath may be used for the same purpose.
bleeding.
C. VOIDING
a. note color, amount and odor of the lochia
D. BREAST CARE
b. count the number of pads that are saturated in
1. Inspect nipples for reddening, erosions or
each 8-hour period.
fissures.
2. Teach woman to wash her breast with warm 1. Healing occurs within 2-4 weeks
water and NO soap.
2. Intercourse may be resumed when perineal and
E. DIET AND ELIMINATION uterine wounds have healed.
• Hygiene
POSTPARTAL PSYCHOSOCIAL CHANGES
-Advise regular perineal care
-This phase is an optimum time to teach the a. Clamping of the cord after 1 to 3 minutes – until
mother about baby care the umbilical cord stops pulsating decreases
anemia in 1 out of every 3 premature babies
o Generally, this phase occurs when the mother
and prevents brain hemorrhage in one out of
returns home.
two. It prevents anemia in one out of every
o During the letting go phase, the woman finally seven term babies.
accepts her new role and gives up her old roles
like being a childless woman or just a mother of b. After the umbilical pulsation stopped( 1-3min)
one child. clamped the cord using a sterile plastic clamp
or tie at 2 inches from the newborn umbilical
o This is the phase where postpartum depression base.
may set in.
c. Clamp again at 5 cm from the base
o Readjustment of relationship is needed for an
easy transition to this phase. d. Cut the cord close to the plastic clamp with
sterile instrument
o Generally, this phase occurs when the mother 4. Non-separation of baby from mother, and
returns home. breastfeeding initiation- Keeping the mother
and baby in uninterrupted skin to skin contact
o During the letting go phase, the woman finally prevents hypothermia, increases colonization
accepts her new role and gives up her old roles with protective family bacteria and improves
like being a childless woman or just a mother of breastfeeding initiation and exclusivity.
one child. Breastfeeding within the first hour of life
prevents an estimated 19.1% of all neonatal
o This is the phase where postpartum depression
deaths
may set in.
WITHIN 90 MINUTES OF AGE and summarily assess the health of newborn
Note: Do not give sugar , water, formula, pre lacteals -Apgar was an anaesthesiologist who
developed the score in order to ascertain the
effects of obstetric anesthesia on babies.
• Mandatory – done to all newborns -The resulting Apgar score ranges from zero to
Drugs used – 1% Silver Nitrate 1 – 2 gtts into 10.
each conjunctival sac and Terramycin
opthalmic 1 cm • The five criteria are summarized using words
chosen to form (Appearance, Pulse, Grimace,
-CORD CARE Activity, Respiration).
-1 cm in length
• Profile of a Newborn
-Closes at 2-3 months
A. Head D. Nose
B. Eyes E. Mouth 2. SUTURES
C. Ears
-Skull sutures
-Disproportionately larger than the body -May override at birth because of extreme
pressure exerted by the passage of fetus thru the
-¼ larger than the body canal.
-soft spot where sutures cross meet -swelling of the soft tissues of the scalp because
of pressure from the cervix against presenting
-Too easily felt or identified part. Usually caused by continuous pressure of
-Should be flat and open; enlarged or bulging undelivered head against the partially dilated
may indicate increased intracranial pressure, cervix.
sunken often indicates dehydration. -Edema of the presenting part (head)
-Edema is gradually absorbed -Chlamydia, Glaucoma, Edema, Opthalmia
neonatorum,
-Disappears at 3rd-4th day of life without Trabismus and Twitch
intervention.
B. EYES
-Newborns cry tearlessly- immature lacrimal duct,
matures at 3 mos.
-Color of eyes gray or blue
-Sclera- blue, thinness
-Permanent color 3-12 mos