abnormal growth in pregnancy Flashcards
what is SGA
birth weight <10th decile
how is SGA diagnosed
abdominal circumference (AC) or USS to estimated foetal weight
what is a low birth weight
any baby born under 2.5kg
what is Fetal growth restriction
abdo circumference or estimated foetal weight below 3rd decile (or below 10th + placental dysfunction)
RF SGA
placental dysfunction // maternal infection // congenital or chromosomal abnormality // smoking, alcohol, drugs
consequences of prematurity
Resp distress // intraventricular haemorrhage // nec enterocolitis // lung disease, hypothermia, feeding problems, infection, jaundice // retinopathy // hearing problems
when does retinopathy occur in prematurity
before 32 weeks
what is macrosomnia
baby over >90th decile // over 4.5kg
what is polyhydramnios
excess amniotic fluid
causes polyhydramnios
maternal diabetes!! // foetal anomaly // twins // virus // hydrops fetalis
signs polyhydramnios
tense, shiny bump // cant feel fetal parts // large for dates
invx polyhydramnios
USS
what is oligohydramnios
reduced amniotic fluid (<500ml at 32-36 weeks)
causes oligohydramnios
PROM // potter sequence (renal agenesis) // IUGR // post term // pre-eclampsia
RF twins
FH // increased maternal age // multigravida // IVF // afro-carribean
what is Zygosity and Chorionicity
zygosity = no of eggs (eg monozygous from 1 egg, dizycgous from 2) // chorionicity = number of placentas
what type of chorionicity do dizygotic twins have
dichorionic (2 placenta) and diamniotic (2 sacs)
what type of chorionicty can monozygotic twins have
DCDA, MCDA, MCMA, conjoined
what determines a monozygotic twins chorionicty
date of cleavage
most common chorionicty for monzygotic twin
MCDA (1 placenta, 2 sacs)
symptoms twins
exaggerated pregnancy // large for dates // multiple fetal poles
complications twins
polyhydramnios // hypertension // aneamia // APH, PPH // cord entanglement // premature // fetal death // growth restriction // twin to twin transfusion
complication and invx from single fetal death
risk nuero abnormality to other twin // MRI at 4 weeks
what is twin to twin tranfusion syndrome
donor perfuses recipient twin
consequences twin to twin tranfusion syndrome donor
restricted growth, anaemia, decreased blood volume, oligohydramnios
consequences twin to twin transfusion syndrome recipient
polyhydramnios and HF
mx twin to twin tranfusion
<26 weeks = laser ablation // >26 weeks = amnioreduction // >34 weeks = delivery
delivery twins
most by 38 weeks, induce by 38-40
supplements for twins
iron and folate
types of foetal lie
longitudinal, transverse, oblique
when do most transverse lie move to longitudinal
32 weeks
RF transverse lie
previous pregnancy // fibroids // twins // premature // polyhydramnios
complications transverse lie
PROM // cord prolapse // compound presentation
mx transverse lie
external cephalic version // elective c section
what is post-term pregnancy
extended beyond 42 weeks
neonatal complication post-term pregnancy
reduced perfusion // oligohydramnios
maternal complications post-term pregnancy
increased chance of forceps or c section // labour indcution
