Foetal Growth

Question 1

What is SGA & LGA?

Answer 1

SGA <10th centile

LGA >10th centile

Question 2

What is LBW & macrosomia?

Answer 2

LBW <2500g

Macrosomia >4kg

Question 3

Describe the different patterns of growth in SGA.

Answer 3

Symetrical- head and body small, due to early insult means poor cell hyperplasia
Asymetrical- Head large body small, due to later insult, placental insufficiency so blood is shunted from liver to brain.

Question 4

Describe how you could tell clinically asymmetrical growth?

Answer 4

Brain to Liver ratio of 6:1 or higher.

Is usually 3:1

Question 5

What are the risk factors for IUGR?

Answer 5

>35,
Smoker 
High or low BMI 
Coccaine
Pre-eclampsia 
HTN
DM

Question 6

Describe the potential causes of IUGR.

Answer 6

1) Maternal :Chronic disease, Pre-eclampsia, Malnutrition
Infection, Drugs/alcohol.
2) Foetal: Multiple pregnancy, Infection, congential (trisomy)
3) Placental : Poor invasion, TTTS, Lateral chord insertion, abruption

Question 7

How is foetal growth assessed?

Answer 7

1) RF screen
2) Symphosiofundal height + maternal weight
3) USS- AFI, foetal growth
4) Uteroplacental doppler
5) genetic analysis

Question 8

How can IUGR be prevented

Answer 8

Low dose aspirin in women with RFs

Decrease RFs

Question 9

What are some of the risks of macrosomia?

Answer 9

Maternal diabetes
Foetal demise
Shoulder dystocia–> erbs palsy
Neonatal hypoglycemia