3POSTNATAL CARE AND MANAGEMENT BASED ON CASE STUDYat 26 weeks of pregnancy as well. Along with that her previous two children were both bornprematurely close to two years apart; Yvette is extremely stressed and is a heavy smoker with 20cigarettes a day, and her premature labour is tensing her further. Based on the finding of this casestudy the two major risk factors that could have positively contributed to her premature labourare smoking and her past history of recurrent preterm births (MacIntyre et al., 2012). There are a variety of adverse effects of smoking on the health and wellbeing of a normalindividual, in case of pregnancy however; the risk factors increase multiple folds. According to alarge number of exploratory study, smokers were found to be on an elevated risk of pre termdelivery, along with that, the risk for preterm birth increased with the increase in number. Forinstance, heavy smoker mothers had the greater risk of 24% for very preterm labour, 28% forspontaneous birth, and 28% of medically indicated preterm labour. However, the exact pathwaythrough which smoking escalates the risk for preterm birth is not completely known yet (Khan etal., 2010). Although extensive research has discovered that excessive concentration of nicotineand carbon monoxide in the system, compromising the placental blood flow, which in turndisrupts the vasoconstriction of the placental vessels. Along with that the carbon monoxidepresent in the tobacco smoke is also known to produce carboxy- hemoglobin interfering with thefetal oxygenation (Tsiartas et al., 2012). The nicotine accumulated in the body system of asmoker is also known to increase the maternal blood pressure and pulse rate, which in turnrestricts the blood flow to the fetus. The culmination of all these factors ultimately results inaltering the amniotic environment for the fetus and restricts the growth and development of thefetus, leading to the preterm labour; idiopathic preterm labour is also associated with theexcessive smoking in pregnant woman and is rightfully considered one of the biggest risk factorsto preterm delivery in woman (Olsson, Ahlsén & Eriksson, 2016).

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