Fetal Monitoring Flashcards
Causes for intrinsic symmetrical IUGR
parental factors (ethnicity), chromosomal abnormality, TORCH infections, anatomical abnormality like cardiac disease or gastroschisis
Causes of extrinsic asymmetrical IUGR
Reduced liquor, abnormal placenta, preeclampsia, SLE, antiphospholipid syndrome, cigarettes, uterine abnormality, multiple pregnancies, later infections
Risk of reoccurrence with IUGR
40%
What measurements are taken on fetus USS if they are concerned about growth and development?
BPD, HC, AC, FL, TCD (transcerebellar diameter an early growth restricted sign)
What is Dolichocephaly and when is it common
Oval shaped head usually in breached babies
What measurements do you need for the estimated fetal weight?
BPD, FL, AC
How do you personalise growth charts?
Booking weight, height, BMI, age, ethnicity
Investigations performed in symmetrical IUGR?
Dates, mother and father weight and build, ethnicity, previous babies, TORCH scan, USS for abnormalities, drugs/alcohol, fetal ECHO, karyotype, doppler scan for flow
Index taken during assymetrical growth?
Amniotic fluid index
list the timeframes associated with each grade of placenta
0 = late first trimester early second, 1 = mid second to early third, 2 = late third trimester (30 weeks), 3 = 39 weeks
What does the placenta grading predominantly focus on
Indentations of the chorionic plate through the basilar plate and calcifications developing
What areas can the fetal doppler look at (2)?
Umbilical artery and MCA
2 abnormalities fetal Doppler is looking for during umbilical artery flow?
is there reversed EDF? is EDF present?
What does Doppler of the ductus venosus show?
If there is any cardiac decompensation present and potential urgent delivery needed
If a woman has abormal Doppler and movements what will you do?
steroids and aim to get to 37 weeks
How often does a woman need Dopplers to monitor asymmetrical IUGR when she is 28-37 weeks pregnant?
every 2 weeks if normal flow through umbilical artery but weekly if there is resistance, alternate days if there is absent EDF, deliver baby if there is reversed EDF
with the nuchal scan how many mm of fluid should be present behind the babies neck?
3mm
Absent nasal bone is indicative of what?
Downs Syndrome
How many weeks is the quadruple test performed?
15-20 weeks
When is the combined test performed?
first trimester 11-13+6
What test for Downs Syndrome can be performed in the late stages of pregnancy?
NIPT
What can you give to reduce chances of IUGR in future pregnancies?
Aspirin
3 phases of normal growth in utero including timings and predominant growth type
phase 1 is 0-16 weeks (cellular hyperplasia), phase 2 is 16-32 weeks (cellular hyperplasia and hypertrophy), phase 3 is 32 weeks to term (hypertrophy)
What morbidity in later life are IUGR babies predisposed to?
Glucose intolerance, insulin resistance, T2DM
