Pointers Make a p ysica examrnation olhgt &-Leopold's maneuver for the fetal position, Ile and presentation, lntema I i!Xamination to determlne pelvic adequacy, rupture of membranes, engagement and signs of Imminent delivery This presupposes that the nurse had previous trralning on Internal e>camination _ (IE), The nurse can also use maternal height as a possible predictor of cephalo-pelvlc disproportion. 1nspec:t abdomen for CS scarfs. comp ete ata on present eal condition an past obstetric history with emphasis on the following : Presence of a medical condition, hlstory,of difficult delivery, prolonge d labor, hemorrhage-o r previous caesarean section For rmme ate re erra, t e i Ft atten ant must accompany the patient together with a relative. Forother refi?rral s, the birth attendant may not accompany the patient but Instead make a referral slip which Include the following information, a5 suggested by the DOJ,l: name, complete address, age and reason for referral Qualifications For Home Dellve Cep allc presentatfon Pelvic: adequacy No premature rupture of membranes Imminent-delivery Di cu t and pro onged la-or (greater than 24 hours for prlmlgra111das and more than 12 hours for multigravidas) durfng previous deli Vfilries Hislory of hemorrt,age.. A previous caesarean section Imm ate re erra must e done to the nearest faclllty with cap. ibllity of handling the needed servlce/s in the following sfgns: DANGER : Vaginal bleeding. ·convulsion Blood pressure above 140/90 Severe abdominal pain Re~rral but not lmmedlarelyr O A pregnant woman who is not qualified for home delhtary A woman who develops abnormal signs and symptoms but NOT dang!!r signs during pregnancy and postpartum like ·edema and pallor 299 