1. IUGR + Talipes Flashcards
How is a small baby defined?
-Birth weight below 10th centile
-May be familiar or due to IUGR
-Two types:
–Symmetrical (caused by early insult in pregnancy)
–Asymmetrical (caused by late insult eg placental insufficiency)
What can cause IUGR?
-Constitutional ie small parents (most common)
-Multiple pregnancies
-Placental insufficiency
-Maternal factors eg smoking, alcohol drugs
-Congenital infections eg toxoplasmosis, rubella
-Genetics eg Down’s syndrome
How can you investigate IUGR?
-Growth charts
-Doppler / US to detect abnormalities of blood flow in umbilical / foetal blood vessels and can be used to determine when to intervene
What complications can arise from IUGR?
-Increased risk of death / asphyxia
-Hypoglycaemia due to decreased glycogen
-Hypothermia
-Polycythaemia (increased Hb in blood)
-Necrotising enterocolitis / intolerance to feeds
-Bone marrow / hepatic compromise
-Meconium aspiration syndrome
-Retinopathy of prematurity (iatrogenic - high o2 therapy)
How should you manage IUGR?
-Ideally on postnatal ward for routine care
-Assess for underlying cause
-Thermal care and BG monitoring, HR and respiration
-Discharge if:
–Feeding well
–Satisfactory weight gain
–Body temp maintained
–Mother happy
What is the prognosis for IUGR?
-Normally ‘catch-up’ in first 2 years of life
-?Insulin sensitivity effects
What is Talipes?
-Neonatal club foot
-More common in males, bilateral in 50%
FEATURES:
-Inversion
-Adduction of the forefoot relative to handout
-Plantarflexion deformity
What conditions is talipes associated with?
-Spina bifida
-Cerebral palsy
-Edward’s syndrome
-Oligohydramnios
-Arthrogryposis
How can you treat talipes?
-Physio for mild cases
-Ponseti method = foot manipulation by placing it in a long leg plaster cast repeatedly (severe)
-Surgery on soft tissue / bones may be carried out from 2y
