Antenatal: SGA, LGA, Abnormal Lie, Multiple Pregnancy Flashcards
Define small for gestational age
Weight or abdominal circumference below the 10th centile for age
How will placental factors present on growth chart
Asymmetric growth.
Head circumference is preserved, but abdominal circumference is reduced
Why does asymmetrical growth occur
As foetus tries to preserve nutrients
What are placental causes of SGA
Placental insufficiency:
- Abruption
- Pre-eclampsia
How will foetal factors of SGA present on growth chart
Symmetrical growth restriction
What are the 3 categories of foetal factors of SGA
Congenital Anomalies
Infection
Multiple pregnancy
What genetic anomalies may cause SGA
Down syndrome
Edward’s
Patau’s
What congenital infection anomalies may cause SGA
Rubella
CMV
Give 10 major risk factors of SGA
>40 Smoking Cocaine-use Chronic HTN Antiphospholipid Renal insufficiency Diabetes Low PAPP-A Ecogenic bowel APH Pre-eclampsia Previous SGA Previous still-birth Mother/Father SGA
Give 5 minor factors for SGA
>35 BMI<20 Nulliparous IVF PIH
Explain assessment for SGA
Women is assessed at booking for risk of SGA. All women are given a personalised growth chart based on BMI, Age, Ethnicity, Previous parity and Birth weight of previous children
When should any women be referred for US scan
If SFH <10th centile
Explain management of women considered at risk of SGA at booking
Serial growth scans every 2-3W
US doppler at 28W
If a women has 3 or more risk factors for SGA what is she offered
US doppler at 24-26W
If the umbilical artery is normal on US what is done
Aim for IOL at 37W
If umbilical artery is abnormal on US what is done
Aim for pre-term delivery
Up to what time frame will women need corticosteroids
Up to 35+6
If umbilical artery is absent or shows reversed end-diastolic flow on doppler what is done
Urgent LSCS
What are immediate risks to foetus with SGA
Cerebral palsy
Neonatal morality
Still-Birth
What are SGA children at increased risk of in adult life
T2DM
Thyroid disease
HTN
CAD
Define large for gestational age
Baby above 95th centile for weight
What are 3 risk factors for large-gestational age
FH
Obese mother
Diabetes
What are complications of LGA
Shoulder dystocia Hypoglycaemia Hypocalcaemia Polycythaemia - leading to jaundice Left colon syndrome
What is left colon syndrome
Self-limiting condition that mimics Hirschsprung’s by cause temporary bowel obstruction
