Big babies Flashcards
commonest reason for large for date baby
obesity
what is large for date
Symphyseal-fundal height >2cm for Gestational age
risks of having a big baby
- clinican & maternal anxiety
- Labour dystocia
- Shoulder dystocia- more with diabetes
- PPH
management of a large for date baby
- exclude diabetes
- Reassure
- Conservative vs IOL vs C/S delivery
polyhydramnios definition
- excess amniotic fluid
- deepest pool >8cm
- Amniotic Fluid Index (AFI >25cm)
polyhydramnios causes
maternal:
- diabetes
- red cell antibodies
fetal:
- Anomaly: GI atresia, cardiac, tumours
- Monochorionic twin pregnancy
- Hydrops fetalis – Rh isoimmunisation
- Viral infection (erythrovirus B19, Toxoplasmosis, CMV)
Idiopathic
polyhydramnios clinical features
- abdominal discomfort
- preterm labour
- pre-labour rupture of membranes
- cord prolapse
polyhydramnios investigations
- OGTT
- viral serology
- antibody screen
- USS
what increases risk of multiple pregnancy?
Assisted conception
Race- African
Geography - Nigeria 40-50/1000 ( 1 in 25)deliveries
Family History
Increased maternal age
Increased Parity
Tall women> short women
are multiple pregnancies more likely to be monozygotic or dizygotic?
dizygotic
multiple pregnancy antenatal management
- Fe supplementation
- Low dose aspirin
- Folic acid
- USS - lots
What is Twin-To- Twin Transfusion Syndrome (TTTS)?
This happens when identical twins share a placenta (monochorionic). Abnormal blood vessel connections form in the placenta. They allow blood to flow unevenly between the fetuses.
what does monochorionic twins mean?
identical twins that share a placenta
diabetes in pregnancy complications
- pre-eclampsia
- polyhydramnios (too much amniotic fluid around the baby)
- macrosomia (big baby)
- shoulder dystocia
- neonatal hypoglycaemia
in diabetes, above what HBA1C level should pregnancy be avoided?
Above 86 mmol/mol
