Fetal Growth Disturbances & Prematurity Flashcards by Benjamin Chan | Brainscape

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What is SGA?

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Major differences between preterm and SGA babies

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What are the external features assessed on the clinical assessment of maturity - scoring system (New Ballard score, modified from Dubowitz)?

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Neurological assessment (relative flexor tone of 4 limbs)

[New Ballard score, modified from Dubowitz]

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Don’t use this scoring for neurologically abnormal baby

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What is Intrauterine Growth Restriction?

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SGA is statistical term

Assessment of foetal growth must be based on statistics from that ethnicity

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Q

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Yellow: IUGR (initially normal, but gets worse = look at the course)
Red: SGA (small from the start)

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What is the consequence of reduce growth support?

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% reduction in organ weight in SGA baby compared to normal counterparts

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Pathological factors associated with slow foetal growth

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What are fetal and placental factors?

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What are embryopathies?

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What. areconstitutional and genetic factors causeing slow feotal growth>

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Idiopathic causes for SGA

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History, ultrasound, p/e

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Special problems of SGA babies

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Lower reserve

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Glucose disturbance in SGA babies

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Hypothermia in SGA babies

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CBC issue in SGA babies

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Cardiorespiratory problems in SGA babies

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What are some primary causes of SGA in babies?

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Hepatosplenomegaly
Hearing loss
Intracranial calficiations
Blueberry muffin baby

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Management of SGA babies

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What must be done during resuscitation of SGA baby?

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Dextrose gel may be used before mother can breastfeed

Search for underlying cause

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Q

Future growth and development of SGA babies
- Catch up growth
- Neurodevelopmental sequalae

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Long-term implications of SGA babies

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I.e. blood will be diverted to brain, instead of gut, liver, pancreas = in adulthood, more prone to adult disease due to poorer development of these organs

Metabolic syndrome risk is greater

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Complicatoins of infant of diabetic mother

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What is preterm, very preterm and extreme prematurity?

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What is associated with spontaneous premature birth?

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Foetal and socioeconic factors with spontaneous premature birth

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Problems related to prematurity

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What is RDS?

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Surfactant is made at around 30-32 weeks
Mother with diabetes

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Widreslread collapsed membrane in alveoli

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Factors predisposing to RDS: Sex, C-section, maternal, familial

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Factors predisposing to RDS

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What is the usual cord clamping time in labor ward?

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~ 1 min, unless there are other causes

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Factors protecting against RDS

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Clinical diagnosis of RDS

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Bilateral lung fields are white-out
Cannot see cardiac border
Air bronchograms (atelectasis)
Reduce no. of ribs = lung voluem diminished

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What is done for prevention of RDS?

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What are other causes of respiratory distress?

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Treatment of RDS

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Nasal CPAP or nasal IMV

Prevent lung complications, which may persist into later life

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What are neurological complications in RDS?

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RF for IVH/PVH

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missing slide

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Blood clot inside IVH

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Management of PVH / IVH

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Enlarged lateral ventricels

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What is periventricular leucomalcia?

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Neuroreduction in

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Nutritional management in premature infant

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Enteral feeding

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What is NEC?

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RF for NEC

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XXX

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DISTENS

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CLINIACL EFATURES OF NEC

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Prevention of NEC

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Breast milk = evidence-based

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Treatment of NEC

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Late complications related to prematurity

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