home *** CD-ROM | disk | FTP | other *** search
/ Parenting - Prenatal to preschool / Parenting_PrenatalToPreschool.bin / dp / 0026 / 00266.txt < prev    next >
Text File  |  1993-06-25  |  2KB  |  69 lines
  1. $Unique_ID{PAR00266}
  2. $Font{NP}
  3. $Pretitle{}
  4. $Title{Information Charts:  History of Pregnancy and Delivery}
  5. $Subtitle{}
  6. $Author{
  7. Lansky, Vicki}
  8. $Subject{Information Charts PREGNANCY DELIVERY HISTORY}
  9. $Log{}
  10.  
  11. Complete Pregnancy and Baby Book
  12.  
  13.  
  14. Information Charts:
  15.  
  16. HISTORY OF PREGNANCY AND DELIVERY
  17.  
  18. Obstetrician                           Pediatrician
  19.  
  20. Name _______________________________   Name _______________________________
  21.  
  22. Address ____________________________   Address ____________________________
  23.  
  24. City/State _________________________   City/State _________________________
  25.  
  26. Length of pregnancy (full term, eight months, other) ______________________
  27.  
  28. ___________________________________________________________________________
  29.  
  30. Medications taken during pregnancy, if any
  31. (sleeping pills, aspirin, cough medicine, other) __________________________
  32.  
  33. ___________________________________________________________________________
  34.  
  35. Complications during pregnancy (bleeding, swelling, high blood pressure,
  36. infections, illness, exposure to German measles or other infectious diseases)
  37.  
  38. ___________________________________________________________________________
  39.  
  40. ___________________________________________________________________________
  41.  
  42. Onset of labor (specify premature, spontaneous, induced) __________________
  43.  
  44. ___________________________________________________________________________
  45.  
  46. Length of labor ___________________________________________________________
  47.  
  48. Medical assistance during delivery (specify forceps, episiotomy, anesthesia)
  49.  
  50. ___________________________________________________________________________
  51.  
  52. Type of delivery (vaginal, cesarean) ______________________________________
  53.  
  54. Position of baby during birth (head first, breech) ________________________
  55.  
  56. Condition of baby at birth (specify color, spontaneous respiration, immediate
  57. crying)
  58. ___________________________________________________________________________
  59.  
  60. Medical treatment necessary (oxygen, resuscitation, blood transfusion, other)
  61.  
  62. ___________________________________________________________________________
  63.  
  64. Congenital abnormalities __________________________________________________
  65.  
  66. Hospital nursery used (specify newborn, premature, high risk) _____________
  67.  
  68. ___________________________________________________________________________
  69.