Abnormal Birth Size

Question 1

What is defined as preterm?

Answer 1

Anything before 37 weeks

Extreme preterm is 24-27 weeks

Question 2

What % of UK population deliver preterm>

Answer 2

6-7%

Question 3

Give 5 risk factors for preterm labour

Answer 3

Age (teenagers)
Low BMI
Smoking 
Multiple pregnancies 
Parity (0 or >5)

Question 4

Give five causes of preterm labour?

Answer 4

Infection/illness
Idiopathic
Multiple pregnancies
Cervical incompetence
Placental abruption

Question 5

What % of babies born at 24 weeks survive?

Answer 5

19%

Question 6

Define Intrauterine growth restriction (IUGR)

Answer 6

Failure of the foetus to achieve growth potential

Question 7

What qualifies as a low birth weight?

Answer 7

2.5 kg birth weight, regardless of gestation

Question 8

Define small for gestational age (SGA)

Answer 8

When the estimated foetal weight/abdominal circumference is below the 10th centile

Question 9

What is symmetrical IUGR?

Answer 9

When both the head and abdomen are small

Question 10

What is asymmetrical IUGR?

Answer 10

When the head is normal size but the abdomen is small

Question 11

How do we identify SGA?

Answer 11

Through assessing risk factors and screening (e.g. symphysial-fundal height)

Question 12

What maternal factors can cause SGA? (Give 5)

Answer 12

Smoking
Drugs
BMI
Age
Maternal disease

Question 13

Give two placental causes of SGA

Answer 13

Infarct

Abruption

Question 14

Give three examples of foetal causes of SGA

Answer 14

Infection (e.g. rubella)
Congenital abnormalities (absent kidneys) Chromosomal abnormalities (Downs)

Question 15

What risk does IUGR carry durng labour?

Answer 15

Hypoxia leading to death

Question 16

What risks are there to IUGR post natal.? (give 6)

Answer 16

Hypoglycaemia
Hypothermia
polycythaemia
Hyperbilirubinemia
Abnormal neurodevelopment
Asphyxia s/e's

Question 17

What 2 investigations can be done to assess foetal well being?

Answer 17

Cardiotocography

Doppler ultrasound

Question 18

What features are assed in a biophysical profile?

Answer 18

Movement
tone
Foetal breathing movements
Liquor volume

Question 19

What assesses placental resistance to flow?

Answer 19

Umbilical arterial doppler

Question 20

Why do we give steroids when planning preterm labour?

Answer 20

To stimulate surfactant production in foetal lungs.

Question 21

What size is considered large for dates?

Answer 21

When the sympyseal-fundal height is >2cm for gestational age

Question 22

What is Foetal Macrosomia?

Answer 22

When a baby is large for its gestational age

USS EFW >90th centile

Question 23

What risks are there with macrosomia baby?

Answer 23

Shoulder dystocia
Labour Dystocia
Maternal anxiety
Post-partum haemorrhage

Question 24

Define polyhydramnios:

Answer 24

Excess amniotic fluid where the deepest pool is >8cm and the AFI is >25cm

Question 25

Give 5 potential causes of polyhydramnios

Answer 25

``` Idiopathic Gestational Diabetes Monochorionic twin pregnancy Viral infection Anomalies in foetus (eg atresia) ```

Question 26

Give 4 symptoms of polyhydramnios

Answer 26

Abdominal discomfort Prelabour membrane rupture Preterm labour Cord prolapse

Question 27

Give 4 clinical signs of polyhydramnios

Answer 27

LFD Malpresentation Tense shiny abdomen Inability to feel foetal parts

Question 28

What investigation will confirm polyhydramnios?

Answer 28

Ultrasound showing AFI >25cm and DVP >8cm

Question 29

What other investigations can be done when checking for polyhydramnios?

Answer 29

Oral Glucose Tolerance Test Serology Antibody screen USS (foetal lips and stomach etc)

Question 30

Give 5 risk factors for multiple pregnancy?

Answer 30

``` Ethnicity - African highest FHx Increased Maternal Age Increased Parity Assisted conception ```

Question 31

Define monochorionic

Answer 31

This is when 2 foetus's are sharing one placenta,

Question 32

Define dichorionic

Answer 32

When 2 foetus's have their own placenta

Question 33

Define diamniotic

Answer 33

When each foetus is in its own amniotic sac

Question 34

Define monoamniotic

Answer 34

When both foetus's are within the one amniotic sac

Question 35

What type of twins are at an increased risk of pregnancy complications?

Answer 35

Monochorionic / Monozygous

Question 36

At what stage do you confirm multiple pregnancy?

Answer 36

USS at 12 weeks