[61] Intrauterine Growth Restriction Flashcards
What is IUGR?
Refers to poor growth of fetus while in the mothers womb during pregnancy
What are the major categories of IUGR?
- Symmetrical
- Asymmetrical
What kind of IUGR is more common?
Asymmetrical
What % of cases of IUGR are asymmetrical?
70%
What happens in asymmetrical IUGR?
There is a restriction of weight followed by length, but the head continues to grow at normal or near-normal rates, called head sparing
What does a lack of subcutaneous fat lead to in asymmetrical IUGR?
A thin and small body out of proportion with the liver
When does asymmetrical IUGR occur?
When the embryo/fetus has grown normally in the first 2 trimesters, but encounters difficulties in the third
What is asymmetrical IUGR most commonly caused by?
Extrinsic factors that affect the fetus at later gestational ages
What does symmetrical IUGR indicate?
The fetus has developed slowly throughout the duration of the pregnancy, and thus was affected from a very early stage
Is the head circumference of the newborn with symmetrical IUGR in proportion to the rest of the body?
Yes
Is permanent neurological sequelae more common in symmetrical or asymmetrical IUGR?
Symmetrical
Why are permanent neurological sequelae more common in symmetrical IUGR?
Because most neurones have developed by 18 weeks gestation
Give 4 examples of causes of symmetrical IUGR
- Early intrauterine infection
- Chromosomal abnormalities
- Anaemia
- Maternal substance abuse
What are the categories of causes of IUGR?
- Maternal
- Uteroplacental
- Fetal
What are the maternal causes of IUGR?
- Pre-pregnancy weight and nutritional status
- Poor weight gain during pregnancy
- Poor nutrition
- Anaemia
- Alcohol, smoking, or drug-use
- Pre-gestational diabetes or gestational diabetes
- Pulmonary, renal, or cardiovascular disease
- Hypertension
- Coeliac disease
