Fetal growth problems Flashcards
Development vs growth
First 12 weeks fetal development occurs- organs formed
Then the baby needs to get bigger- fetal growth
Small gestational age
<5th centile
Normal variant or growth restricted
Intra-uterine growth restriction
<5th centile
Growth restricted
Fetal growth restrictions
Deficient placental invasion
Reduced placental reserve
Fetal need exceeds supply
IUGR
Hypoxia
Fetal vascular redistribution
Oliguria
Abnormal CTG
Fetal death
Diagnosis
Clinical suspicion- abdomen looks smaller
Clinical measurement of uterine size: symphysis- fundal height
Early fetal growth restriction
Symmetrical growth restriction: both head and abdominal growth affected
Causes of symmetrical growth restriction
Chromosomal anomaly (T21)
Viral infection (rubella, CMV)
Severe placental insufficiency OR normal small baby
Asymmetrical growth restriction
Just abdominal growth affected
Abdominal circumference reflects the size of the fetal liver
Causes: placental insufficiency
- no excess glycogen being deposited within the liver
Consequences of hypoxia in the fetus
Blood flow redirected to areas of greater importance
- brain
Blood flow redirected away from areas of lesser importance -
- gut
- kidneys
- lungs
Ultrasound findings in IUGR
Small AC
Decreased amniotic fluid
Increased blood flow to the brain
Clinical features of IUGR
SFH smaller than expected
baby’s movements lessen to conserve energy
Fetal heart rate changes as hypoxia develops
Fetal death
Betamethasone/ dexametasone
When given to the mother will cross the placenta and stimulate the alveoli cells to produce surfactant gene
Surfactant stops the collapse of the alveoli cells by coating the cells and reducing the surface tension
Helps prevent respirating distress syndrome which leads to neonatal death in premature babies
Produced from 24-24 weeks and usually the baby will have enough by 34 in preparation for a term delivery
In premature babies it is lacking
