Identification: (age, city, literacy, marital status).
Obstertric history: (pregnancies, abortions,
deliveries, live born, death born, cesarean delivery,
previous newborns <2.500 grs, previous twins, last
pregnant date).
Pregnancy data:usual weight, height, last menstrual period date, doubts on that, tetanous toxoid vaccination date, Rh factor, smoking, number of prenatal visits; date, gestational age and weight at first and last prenatal visits.
Labour and delivery: day of admittance,
gestational age, presentation, fetal size, onset
labour, integral membranes, method of delivery
(spontaneous, forceps, cesarean), date of delivery,
cause of cesarean delivery.
Mother: pathology of the mother during pregnancy.
Newborn: infant record, sex, weight, lenght, head circumference, gestational age by physical exam, weight for gestational age, apgar at 1th and 5th minutes ,
resucitation, physical exam, neonatal problems,
rooming in, date, food and weight at discharge.