Abnormal fetal growth Flashcards
Define small for gestational age fetus
fetus that has failed to acheive a specific target size or estimated fetal weight by a specific gestational age
what are the two types of small for gestational age fetus?
- constitutionally delayed
- fetal growth restriction
low birth weight =
<2500 grams
very low birth weight =
<1500 grams
Maternal causes of SGA
Smoking
Infections, drug abuse
Hypertension, chronic illness
Fetal causes of SGA
Multiple pregnancy
Fetal malformation
Fetal chromosomal abnormality
Placental causes of SGA
placental insufficiency
Diagnosis of SGA
-EXAM: abdominal palpation and symphyseal-fundal height
Ix: Ultrasound: abdominal circumference, biparietal diameter, femur length, head circumference
-serial measurements 2 weeks apart
What causes asymmetric FGR?
Uteroplacental insuffiency - brain sparing effect
What causes symmetric FGR?
Often from viral infection or chromosomal abnormalities
usually pathologic insult in early pregnancy
Intrauterine complications of FGR?
- hypoxia
- intrauterine fetal demise
Neonatal complications of FGR?
- hyperbilirubinema
- hypoglycemia
- meconium aspiration
- polycythemia
- temp dysregulation
- increase in perinatal mortality
Infant complications of FGR?
- physically small
- delayed neurological development
Adult complications of FGR?
-increased risk of cardiovascular disease and diabetes
Management of FGR?
- Amniocentesis if indicated
- Survellance/fetal wellbeing (growth scans every 2 weeks, doppler, CTG)
- delivery based on doppler findings
- deliver in tertiary centre
