Fetal Growth Restriction Flashcards
What does asymmetrical restriction reflect?
Placental insufficiency
How do you detect FGR?
Fundal height
US
What is the stillbirth risk with FGR?
Higher
What is the definition of FGR?
Estimated fetal weight or abdominal circumference of less than 10th percentile
- But must take in account maternal factors
What maternal factors effect the standardisation of fundal height measures
Parity Height Weight Ethnicity Gestation
What are the biometric factors
Abdominal circumference
Femur length
Biparietal diameter
Head circumference
How do you surveil for fetal health?
Fetal Movements
Fluid index
Umbilical artery doppler +/- MCA doppler and ductus venosus
CTG
What are the best predictors for survival?
Gestational age
Severity of FGR
Birthweight
How do you monitor during delivery?
Continuous CTG
Fetal blood sampling it required
What is the mnemonic for CTG DR C BRAVADO
DR C BRAVADO DR - determine the risk C - Contractions BR - Baseline rate - most commonly occurring HR Variability Accelerations Decelerations O - Overall impression
What do variable decelerations mean?
Cord compression
What do early deceleration mean?
Contraction due to cranial compression
What do late decelerations mean?
Bad - reflect hypoxia
What are causes of fetal bradycardia?
Cord compression / prolapse Head compression / rapid descent Regional anaesthesia Maternal hypotension Tetanic uterine contraction (syntocinon) Maternal seizure Congenital heart abnormality Postmaturity Loss of contact
How do you assess fetal bradycardia?
Abdo exam - soft after contraction
Vaginal examination
If loss of contact - apply fetal scalp electrode
