Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

YR2: Reproduction, Ageing and Development > Foetal growth > Flashcards

Foetal growth Flashcards

1
Q

What simple method can be used to assess fetal growth? What are the advantages of this method?

A

Symphysis fundal height: distance over abdominal wall from pubic symphysis to top of uterus
Simple + Inexpensive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the disadvantages of Symphysis fundal height measurements?

A

Low detection rate: 50-86%
Subjective
Influenced by various factors:
BMI, Fetal lie, amniotic fluid levels, fibroids, wrong LMP date, multiple pregnancy
Fetal weight continues to increase during pregnancy, while length changes less in later stages.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What measure of foetal size is ultrasound used to determine?

A

Crown-rump length until 14 weeks, then head circumference

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Recall the 4 factors that are combined to estimate foetal weight

A

Biparietal (head) diameter
Head circumference
Abdominal circumference
Femur length

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What 2 overarching factors influence foetal growth?

A

Genetic potential: derived from both parents, mediated through growth factors
Substrate supply: sufficient nutrients derived from placenta dependent on uterine + placental vascularity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Define pre-eclampsia

A

Hypertension + proteinuria after 20th week of gestation in a previously normotensive woman + resolving completely by 6 weeks postpartum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the optimum age for child bearing?

A

16-35

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the main risk to the foetus when the mother has pre-natal depression?

A

Maternal cortisol levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the effect of IGF on foetal growth

A

Increases mitotic drive + nutrient availability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the role of cortisol in foetal development?

A

Acts as a TF

Regulates the transition from foetal to adult modes of development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the definition of IUGR / FGR?

A

Failure of infant to reach its predetermined genetic potential for a variety of reasons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the definition of SGA?

A

Birth Weight < 10th centile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Recall the pathophysiology of pre-eclampsia

A

Hypetension causes high shear force reaching placenta
High resistance in umblicial artery
Baby stops moving, diverts blood to try + compensate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a red flag on ultrasound for pre-eclampsia?

A

Lack of foetal movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do the centiles of birth weight charts range?

A

3rd centile: most specific (all captured have FGR, but some may be missed- false negatives)
10th centile: most sensitive (captures all FGR babies, but also those that are SGA- false positives)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When should the term FGR be used?

A

For foetuses with definite evidence that growth has been altered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is IUGR? What are the consequences?

A

Intrauterine growth restriction
IUGR= most common cause of stillborns
Serious consequences for surviving babies
Further increased risk of IUGR in future pregnancies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

List 7 short term problems arising from low birth rate/ prematurity

A 
Respiratory distress
Intraventricular haemorrhage
Sepsis
Hypoglycaemia
Necrotising enterocolitis
Jaundice
Electrolyte imbalance
19
Q

List 3 medium term problems arising from low birth rate/ prematurity

A

Respiratory problems
Developmental delay
Special needs schooling

20
Q

What long term problem may arise from low birth rate/ prematurity?

A

Fetal programming

21
Q

Why is Ultrasound the preferred mode of imaging for assessing fetal growth?

A

No ionising radiation, so safer

Cheaper

22
Q

What could incorrect dating of pregnancy lead to?

A

Inappropriate identification of SGA or LGA

Inappropriate decisions about delivery timings + methods

23
Q

List 4 uses of obstetric ultrasound examination

A

Assessment of fetal “wellness” not just size
Looking at trends in growth
Predicting fetal metabolic compromise
Anticipating need to deliver prematurely

24
Q

Describe the use of centile charts for measuring foetal growth

A

Each parameter is expected to follow a centile, showing steady increases in size
Centiles allow compensation for different sizes of infants that are growing and developing normally.

25
Q

What limitation must be considered when using centile charts?

A

None of these measurements take parental characteristics into account, so theres no consideration of the importance of genetic factors.

26
Q

What are customised foetal growth charts based on?

A

Fetal weight curves for normal pregnancies.
Adjusted to reflect maternal constitutional variation e.g. maternal height, weight, ethnicity
Optimised by presenting a standard free from pathological factors e.g. diabetes + smoking.

27
Q

Define fetal growth

A

Increase in mass occurring between the end of embryonic period + birth

28
Q

What characterises the 3 stages of foetal growth?

A
  1. Cellular hyperplasia (4th-20th week, increase cell numbers)
  2. Hyperplasia + hypertrophy (20-28th week, increase cell size)
  3. Hypertrophy alone (28th-40th rapid increase in cell size, fat, muscle, connective tissue)
29
Q

List 5 maternal factors influencing fetal growth

A 
Poverty: malnourished, uneducated, risky behaviour
Age: Extremes
Drug/ Smoking/ Alcohol use
Diet + weight
Disease
30
Q

List 4 feta-placental factors influencing fetal growth

A

Genotype (determining genetic potential)
Gender (B>G)
Fetal hormones e.g. cortisol
Previous pregnancy (2nd > 1st)

31
Q

How can early IUGR be detected?

A

Fetal size

Umbilical doppler showing abnormal fetal blood flow

32
Q

What is the definition of LBW?

A

< 2500g at delivery (accounting for GA)

33
Q

What are the definitions of VLBW and ELBW?

A

VLBW: < 1500g at delivery
ELBW: < 1000g at delivery
Don’t account for GA, just account for weight at delivery

34
Q

Why is it important to distinguish between LBW due to preterm birth and FGR babies?

A

FGR babies are at greater risk of morbidities + mortalities

35
Q

List 3 maternal medical factors associated with IUGR

A

Chronic hypertension
Pre-eclampsia
Diabetes mellitus

36
Q

List 3 maternal lifestyle factors associated with IUGR

A

Smoking/ alcohol/ drugs
Low booking weight <50kg / malnutrition
Age <16 or >35 at delivery

37
Q

List 3 fetal factors associated with IUGR

A

Multiple pregnancy
Chromosomal abnormalities
Inborn errors of metabolism

38
Q

List 3 placental factors associated with IUGR

A

Impaired trophoblast invasion
Partial abruption/ infarction
Chorioamnionitis

39
Q

Why is there a strong association between pre-eclampsia + IUGR?

A

Main cause of pre-eclampsia is diminished remodelling of spiral arteries by cytotrophoblast, which causes decreased blood flow + hence decreased nutrient supply to placenta + fetus.

40
Q

What unmodifiable maternal factors may increase risk of IUGR?

A

Poor obstetric history
Strong family history
Primips

41
Q

List 4 indications of IUGR

A

Abnormal serum biochemistry
Reduced SFH
Maternal systemic disease e.g. HT, renal, sickle
Uterine artery Doppler: blood flow through uterine arteries: identify high resistance flow

42
Q

How can detection of FGR change plan for delivery? What balance influences timings of delivery in the case of FGR? How is delivery performed?

A

Aim to deliver when ≥28 weeks +/or ≥500g
Risks to fetus if it remains in utero vs. hazards from prematurity
Caesarean section for compromised fetuses

43
Q

Describe 3 characteristics of early IUGR

A

Low incidence 1%
Highly correlated to maternal disease (e.g. preeclampisa)
Difficult to manage: Balancing risks of severe prematurity + morbidity with risk of in utero death

44
Q

Describe 3 characteristics of late IUGR

A

More common 5-7%
Rarely correlated to pre-eclampisa
Difficult to differentiate from constitutionally SGA or placental failure
Easy to manage: deliver at 30 weeks

YR2: Reproduction, Ageing and Development (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions