Fetal Growth Flashcards
What 4 measurements are done during a fetal ultrasound examination?
- Crown rump length
- head circumference
- bi-parietal diameter
- abdominal circumference
What are causative factors for abnormal fetal growth?
Maternal: anaemia, DM, smoking, <16, >25
Foetal: multiple pregnancy, Chromosome abnormality, inborn errors of metabolism
Placental: impaired trophoblast invasion and Preeclampsia
What is SGA?
Small for Gestational Age = birth weight <10th centile
What is FGR?
Fetal Growth Restriction = failure of fetus to acheive its predetermined growth potential
- the term FGR should only be used for fetuses with definite evidence that growth has altered
What centiles are most specific and sensitive in the weight/age centile charts?
10th centile - most sensitive (will capture babies with FGR but also SGA = false positives)
3rd centile - most specific (will capture FGR but some will be missed = false negatives)
What are some complications of LBW/FGR/prematurity?
Acute: Resp distress intraventricular haemorrhage sepsis hypoglycaemia necrotising enterocolitis jaundice electrolyte imbalance
Long term:
resp problems
developmental delay
special needs schooling
maternal risk factors associated with FGR and SGA
hypertension infection DM anaemia malignancy pre-eclampsia smoking poor nutrition age alcohol + drugs high altitude social deprivation
fetal factors associated with FGR and SGA
multiple pregnancy structural abnormality chromosomal ab IU infection errors of metabolism
placental risk factors associated with FGR and SGA
impaired Trophoblast invasion
abruption/infarction
cysts
placenta praevia
Which fetuses need growth monitoring?
bad POHx - hypertension - FGR - still birth - placental abruption Index concerns - serum biochem - reduced symphysis fundal height - maternal systemic disease - antepartum haemorrhage
