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LCRS 1 > Fetal growth > Flashcards

Fetal growth Flashcards

1
Q

Define fetal growth

A

Increase in mass that occurs between end of embryonic period and birth

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2
Q

Simplest way of determining size of infant

A

Palpating maternal abdomen to find symphysis fundal height

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3
Q

What is symphysis fundal height

A

Distance between pubic bone and top of the uterus

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4
Q

Why is symphysis fundal height vulnerable to a variety of errors

A

Data can be lower than actually is due to:
Wrong last period date
Baby is lying transversely
Oligohydramnios

Data can be higher due to:
Maternal obesity
Wrong last period date
Multiple pregnancy

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5
Q

What is oligohydramnios

A

Low amniotic fluid levels

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6
Q

Complications assocaited with baby being larger than expected on SFH

A

Molar pregnamcy
Fibroids
Polyhydramnios
Large baby

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7
Q

What is a molar pregnancy

A

Formed from a previous implanted failed blastocyst that has become a mass

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8
Q

What 4 things are combined to guve estimated fetal weight

A

Biparietal diameter
Head circumfrence
Adbdominal circumfrence
Femur length

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9
Q

What is done with ultrasound data

A

The changes in each parameter are plotted and growth over time is visualised- they are expected to follow a centile showing a steady increase in growth

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10
Q

Why are centiles used totrack growth of fetus’

A

Allows compensation for different sized babies and shows their development is normal

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11
Q

Differences in growth velocity across term

A

14-15 wks= 5g/day
20wks= 10g/day
33wks= 30g/day
>34wks= growth rate drops

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12
Q

Characterisation of normal fetal growth

A 
Cellular hyperplasia (increased cell numbers): 4-20 weeks
Hyperplasia and hypertrophy (increased cell size): 20-28 weeks
Hypertrophy dominates: 28-40 weeks
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13
Q

What is main key factor in fetal weight gain

A

Hypertrophy as most weight gain occurs in final trimester

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14
Q

Issue of using last menstrual period to date pregnancy

A

Confounding factors include irregular length of periods, endometrial bleeding that is abnormal, oral contraceptive use and breastfeeding
Also people who have had unplanned pregnancies are much less likely to be aware of their most recent period

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15
Q

What is best practice to date pregnancy now

A

Crown rump length

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16
Q

How does poverty affect fetal growth

A

Less educated about use of things such as alcohol use during pregnancy
More likely to have disease which can affect baby
More likely to have a baby at younger age

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17
Q

Ideal age for pregnancy for healthy fetus environment

A

16-35

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18
Q

Problem with having baby over 35

A

More inclined to have long pregnancy-> increased risk of death to mother and fetus
More likely to have preterm labour
Increased risk of downsyndrome

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19
Q

Problem with havng baby under 16

A

More likely to have preterm labour which can lead to neurological issues such as irritability, crying and trouble sleeping which affect coping of mother

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20
Q

Effects of weed use during pregnancy

A 
Slows fetal growth
Premature delivery
Low birth weight
Delivery complications
Can lead to addiction
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21
Q

Effects of heroin use during pregnancy

A 
Interrupted development
Stillbirths
Preamture births
GI issues
Large head
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22
Q

Effects of cocaine use during pregnancy

A

Smaller brain so learning issues
Stillborn
Premature

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23
Q

Effects of alcohol use during

A

Facial abnormalities

Affects brain and CNS development -> behavioural issues and retardation

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24
Q

Symptoms of fetal alcohol syndrome

A

Brain abnormalities
Cognitive deficits
Distictive facial features

25
Q

Effects of nicotine use on fetal blood supply during

A

Nicotine constricts blood vessels reducing oxygen supply to baby-> still births

26
Q

Effects of nicotine use on baby if survives

A

Low weight

increased asthma risk due to resp effects

27
Q

Effect of low iron diet on fetus

A

Anaemia

28
Q

Effect of low calcium diet on fetus

A

Poor bone and teeth develpment

29
Q

Effect of low protein diet on fetus

A

Retardation

Smaller fetus

30
Q

Effect of maternal depression on fetus

A

Slower fetal growth

Associated with maternal cortisol levels

31
Q

Effect of gender on fetal growth

A

Males are bigger

32
Q

Effect of previous pregnancies on fetal growth

A

Infants are bigger in subsequent pregnancies

33
Q

Effect of insulin on fetal growth

A

Increases nutrient delivery and mitotic drive not the differentiation of tissue
Modulates IGF
Affects adipose tissue

34
Q

Effects of cortisol on fetal growth

A

Tissue differentiation and maturation

35
Q

How does cortsiol affect fetal growth

A

Directly on cells by altering transcription and post translastional modification- also may initiate switch from IGF II to IGF I

36
Q

Effect of thyroxine on fetal growth

A

affects tissue accretion and differentiation

37
Q

Effect of pituitary growth hormone on fetal growth

A

Very little

38
Q

Difference between IGF II and I in fetal growth

A

II involved in embryonic develompment and I in growth of newborn

39
Q

Effects of fetal glucocorticoids

A

Maturation of surfactant in lungs
Control of glycaemia in liver
Maturation of the expression of digestive enzymes
Proliferation of the villi

40
Q

Proof growth hormone has no effect on growth in fetus

A

No defects present at birth of individuals with deficits

41
Q

Growth factors affecting fetal growth

A

Epidermal growth factors
Fibroblast growth factors
Transforming growth factor

42
Q

Define small for gestational age

A

Infant has birth weight <10th centile

43
Q

Define intrauterine growth restriction

A

Failure for infant to achieve its predetermined genetic potential

44
Q

How heavy is low birth weight

A

less than 2500g at delivery

45
Q

How heavy is very low birth weight

A

less than 1500gmat delivery

46
Q

How heavy is extremely low birthweight

A

less than 1000g at delivery

47
Q

What is linked with IUGR

A

pre-eclampsia

48
Q

What is pre-eclampsia

A

Diminshed re-mdelling of spiral arteries by cytotrophoblasts

49
Q

What is pre-eclampsia associated with

A

Hypertension, proteinuria and oedema

50
Q

Treatment for pre-eclampsia

A

Corticosteroids

51
Q

Receptor for all growth factors

A

Tyrosine kinase linked

52
Q

How are neurotransmitters inhibitted

A

During development cells do have muscarinic receptors on suface but ebryonic cholinesterase is very active through morphogenesis

53
Q

Most common factor amongst stillbirths

A

IUGR

54
Q

Short term complications of IUGR

A 
Respiratory distress
Intraventricular haemorrhage
Sepsis
Hypoglycaemia
Necrotising enterocolitis
Jaundice
Electrolyte imbalance
55
Q

Moderate term complications of IUGR

A

Respiratory problems
Developmental delay
Special needs schooling

56
Q

Long term complications of IUGR

A

Fetal programming

57
Q

When does most IUGR occur

A

Second and third trimester- this is where most growth occurs

58
Q

When does pre-eclampsia tend to occur

A

past 20 weeks

LCRS 1 (58 decks)

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