abnormalities of human development

Question 1

IUGR definition

Answer 1

failure of infant to achieve its predetermined (genetic) potential for a variety of reasons.

Question 2

give a group of infants at increased risk of neonatal complications

Answer 2

Infants who are inappropriately small at delivery

Question 3

what could growth restricted infants be confused with

Answer 3

infants born preterm (who are of low birthweight simply because they have been born too early)

Question 4

when does IUGR generally develop

Answer 4

in the second and third trimesters of pregnancy- almost all weight gain occurs in the later stages of pregnancy

Question 5

what factors can impact fetal growth

Answer 5

Maternal medical factors- chronic HT, connective tissue disease, chronic infection

Maternal behavioural factors- smoking, nutrition, age <16 or >35

Fetal factors- multiple pregnancy, structural/ chromosomal abnormality;

Placental factors- impaired trophoblast invasion, partial abruption/ infarction, chorioamnionitis.

Question 6

name 2 feature of pre-eclampsia

Answer 6

gestational HT and significant proteinuria

Pre-eclampsia occurs in ~5% of pregnancies

Question 7

what are pre-eclampsia and IUGR are both risk factors for

Answer 7

preterm delivery

Question 8

describe the relationship between pre-eclampsia and IUGR

Answer 8

Close link

main cause of pre-eclampsia is diminished remodelling of the spiral arteries
= decreased blood flow
= decreased nutrient supply to placenta and fetus.

Question 9

name a drug administerd for IUGR

Answer 9

Corticosteroids should be administered at gestation to improve neonatal wellbeing, especially lung development

Question 10

what is the ultimate treatment for pre-eclampsia

Answer 10

delivery as the placenta is the primary cause;

emergency caesarean section may be necessary

Question 11

define SGA

Answer 11

birth weight < 10th centile

Question 12

What precautions are taken to detect FGR

Answer 12

size monitoring

Doppler ultrasound of umbilical/uterine arteries

CTGs - fetal heartbeat

Question 13

What is the best way to deal with FGR

Answer 13

monitor and balancing the risks to the fetus if it remains in utero and the hazards from the prematurity

Aim to deliver when ≥28 weeks and / or ≥500g
Caesarean section for compromised fetuses

Corticosteroids to imrpove neonatal well being