Foetal Growth, compromise and surveillance Flashcards
what is the definition for a baby that is ‘small for gestational age’
weight <10th centile for gestation (2.7kg if term)
what is the definition of IUGR
reduction of genetically determined weight in utero due to placental dysfunction
what is the difference between small for gestational age and IUGR
SGA is a statistical thing (<10th centile) whereas IUGR is more personal to the foetus’ genetic potential, for example a baby may be born as 3kg (>10th centile) but was supposed to grow to 4kg, therefore being growth restricted but not small for gestational age
what is the defnition for foetal compromise
Chronic condition describing a situation where the optimum situation for growth and neurological development is not achieved in utero
Usually due to a poor nutrient transfer through the placenta
what are some causes of foetal compromise
IUGR
Prolonged pregnancy
Gestational diabetes
when doing a maternal uterine doppler what is the normal/abnormal reading and what does an abnormal reading mean
low resistance flow = normal
abnormal waveform is bad and flow reversal is worst
abnormal readings indicate potential complications in the 3rd trimester - IUGR, placental abruption, preeclampsia
what gestational age is a maternal uterine doppler reading most sensitive
20-23 weeks
what are methods of foetal growth surveillance
USS
Doppler
CTG
Kick chart
what are the advantages of using USS to determine between constitutional growth delay and IUGR
Allows identification of the pattern of smallness – abdomen stops enlarging before head so abdominal circumference growth reduction rate >30% is indicative of IUGR
Serial scans show not only the rate of growth, but also allows more customisation for the foetuses personal growth compared to the gestational averages
how is flow resistance classified in maternal uterine artery dopplers
High-end diastolic flow
Absent end-diastolic flow
Reversed end-diastolic flow
what kind of pregnancies is maternal uterine doppler most useful for when detecting growth restriction
high risk pregnancies as it detects abnormalities before CTG
what gestational age does maternal uterine doppler become less effective on its own
34 weeks
what are abnormal features on a CTG
Heart rate outside of 110-160
decelerations in heart rate
decreased variability (<5 bpm)
absent accelerations
what gestational age can CTGs be used
26 weeks
what does reduced foetal movement indicate
imminent foetal death