Chapter 53 Fetal Growth Assessment Flashcards
Preterm is __ weeks
Before 37
Early term is _____ weeks
Between 37-39 weeks
Full term is ____ weeks
39-41
Later term is _____ weeks
Between 41-42 weeks
IUGR is most commonly defined as fetal weight below ____ % for given gestational age
10%
Mortality rate is increased ____ depending on severity of IUGR
6-10 fold
Most significant maternal factors with IUGR
- history of previous fetus with IUGR
- smoking
- hypertension
- uterine anomaly
- placental hemorrhage
- placental insufficiency
Difference between IUGR and SGA
IUGR is caused by pathological process
2 classifications of IUGR
Symmetric and asymmetric
More common form of IUGR
Asymmetric
Usually the result of a first trimester insult like chromosomal abnormality or infection.
Symmetric IUGR
IUGR that is also caused by severe maternal malnutrition, fetal alcohol syndrome, severe congenital anomaly. 20-30% of IUGR cases
Symmetric IUGR
Asymmetric IUGR usually results from ____
Placental insufficiency
Assures blood flow to the brain at the expense of the rest of the body
Asymmetric IUGR
Characterized by an appropriate BPD and HC but a disproportionately small AC
Asymmetric IUGR—head sparring
Last organ to be deprived of essential nutrients ____
Brain
The single most sensitive indicator of IUGR ____
AC
Five biophysical parameters included in a BPP
- NST
- Fetal Breathing Movement (FBM)
- Gross Body Movements (GBM)
- Fetal tone(FT)
- AFI
BPP has a _____ minute time limit
30
Normal BPP score
8-10
BPP score with no immediate significance
4-6
BPP score indicating immediate delivery or extending the test
0-2
The goal of the BPP is to find a way to predict and manage the fetus with _____
Hypoxia
Waveforms make sure that blood flow in the umbilical vessels of the fetus with IUGR is ____
Decreased
Fetus with asymmetric IUGR vascular resistance ___
Increases in the aorta & umbilical artery.
Decreases in the middle cerebral artery(MCA)/circle of Willis
Above 90% for EFW
Macrosomia
Macrosomia babies have a birth weight of ____
4000g or greater
Macrosomia is commonly a result of ____
Poorly controlled maternal diabetes
Single most valuable biometric parameter used in assessing fetal growth
Abdominal circumference (AC)
Macrosomic fetus’ have increased risk of morbidity and mortality due to ____
Head/shoulder injuries and cord compression
Macrosomia; ____% in diabetic mothers
25-45%
