Foetal growth and nutrition Flashcards
What are the timings of the 3 stages of foetal development
Stage 1 = 4-20 weeks
2 = 20-28 weeks
3 - 28-40 weeks
When is antenatal screening for trisomies offered?
In the first trimester at the 12 wk scan
What are the methods by which foetal growth can be assessed?
Head circumference
Bi-parietal diameter
Abdominal circumference
Femur length
What can a foetal doppler of the umbilical artery show?
Positive/absent/reverse end diastolic flow in the umbilical artery
What are the causes of growth restricted babies?
Insufficient nutrient delivery gas exchange
Maternal vascular disease
Maternal O2 capacity
Placental damage
What are the causes of intrinsically small babies?
Chromosomal abnormality
Infection
Environmental (foetal alcohol syndrome)
How can a baby be classified as SGA (small for gestational age)
Birth weight < 10th centile
What is PAPP-A, what does it mean if it is low and how is it treated?
Pregnancy associated plasma protein A; low levels associated with poor placentation leading to an increased risk of SGA, pre-eclampsia
Give 75mg aspirin once daily
What maternal factors can lead to an SGA baby?
Diabetes (also LGA)
hypertension -> preeclampsia
active lupus
sickle cell
What foetal factors can lead to an SGA baby?
Multiple pregnancies
foetal structural abnormality
foetal chromosomal abnormality
foetal infection
Do monochorionic or dichorionic twins have a higher risk of complications?
Monochorionic, as they share a placenta
How often are monochorionic/dichorionic twins scanned?
Mono - every 2 weeks
Di - every 4 weeks
At what point in the pregnancy could labour be induced for a baby that’s SGA
37 weeks
What are the potential foetal complications associated with shoulder dystocia?
Brachial plexus nerve injury
fractured humerus/clavicle
birth asphyxia
hypoglycaemia if diabetic pregnancy
What are the potential maternal complications associated with shoulder dystocia?
C-section
Perineal trauma
postpartum haemorrhage
