Fetal growth, compromise and abnormal lie Flashcards
Define small for dates? (1)
Small for gestational age is when the weight of the fetus is less than the 10th centile for it’s gestation.
Define IUGR. (1)
Intrauterine growth restriction is when a fetus has failed to meet it’s growth potential, it implies compromise.
Define a prolonged pregnancy. (1)
Pregnancy over 42 weeks gestation.
What is the management of a SGD fetus? (1)
Monitor growth. No intervention if consistent and umbilical artery doppler normal.
What is the management of IUGR pregnancy? (2)
From 36 weeks: deliver
34-36 weeks: regular umbilical artery doppler; daily CTG, consider delivery
<34 weeks: Give steroids and regular UA doppler, CTG.
Give 3 causes of IUGR. (3)
Maternal: hypertension, pre-eclampsia, diabetes, drug/alcohol abuse, smoking, renal disease, thrombophilia, increased maternal age
Fetal: chromosomal abnormalities, TORCH infection, multiple pregnancy
Other: placental insufficiency
What is the difference between symmetrical and asymmetrical IUGR? (2)
Symmetrical: head and body are proportionately small, normally early onset and seen in chromosomal abnormalities.
Asymmetrical: Typically later onset, abdominal circumference disproportionately smaller than head, seen with placental insufficiency.
Define an abnormal fetal lie. (2)
Lie of fetus is not parallel to long axis of uterus.
Can be transverse or oblique.
name 3 causes of oblique/transverse fetal lie. (3)
Preterm labour, polyhydramnios, multiparty, placenta praevia, multiple pregnancy, pelvic mass, fetal or uterine abnormality
How can a breech presentation be classified? (3)
Extended: both legs extended from knee (70%)
Flexed: both legs flexed at knee (15%)
Footling: oen or both feet are presenting below the buttocks (15%)
How can a breech presentation be managed? (2)
External cephalic version can be attempted from 37 weeks and has 50% success rate.
Caesarian section if failure.
Do not attempt if antepartum haemorrhage, ruptured membranes, fetal compromise or multiple pregnancy.
