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Year Three - Reproductive System > Gestational Weight Abnormalities > Flashcards

Gestational Weight Abnormalities Flashcards

1
Q

What is small for gestational age?

A

A fetus that measures below the 10th centile for their gestational age

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2
Q

What is severe small for gestation age?

A

A fetus below the 3rd centile for their gestational age

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3
Q

What are the two causes for a small gestational age?

A

Constitutionally Small

Fetal Growth Restriction

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4
Q

How do we identify if the cause for a small gestational age is constitutional?

A

They are identified by small size at all stages but growth following the centiles

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5
Q

What does a constitutional cause for a small gestational age mean?

A

There is no pathology present - runs in the familiy

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6
Q

What does a fetal growth restriction cause for a small gestational age mean?

A

There is a small fetus due to a pathology reducing the amount of nutrients and oxygen being delivered to the fetus through the placenta

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7
Q

What are the two categories of fetal growth restriction causes for a small gestational age?

A

Placenta Mediated Growth Restriction

Non-Placenta Mediated Growth Restriction

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8
Q

What is placenta mediated growth restriction?

A

It refers to conditions that affect the transfer of nutrients across the placenta

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9
Q

What are the five placenta mediated growth restriction causes?

A

Maternal Alcohol

Maternal Smoking

Anaemia

Malnutrition

Diabetes

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10
Q

What is non-placenta mediated growth restriction?

A

It refers to pathology of the fetus

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11
Q

What are the three non-placenta mediated growth restriction causes?

A

Structural Abnormalities

Genetic Abnormalities

Fetal Infections

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12
Q

What are the five investigations used to diagnose small for gestational age?

A

Ultrasound Scan

Uterine Artery Doppler

Amniotic Fluid Volume

Cardiotocography

Karyotyping

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13
Q

What two measurements are obtained from an ultrasound scan to diagnose small for gestational age?

A

Estimated fetal weight (EFW)

Fetal abdominal circumference (AC)

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14
Q

What chart is plotted after an ultrasound scan to diagnose small for gestational age?

A

Customised growth charts

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15
Q

What are customised growth charts?

A

Charts to assess the size of the fetus based on the mother’s height, weight, ethnicity and parity

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16
Q

How do we conservatively manage patients with a small gestational age?

A

It involves treating modifiable risk factors, such as smoking cessation and optimising maternal disease

It also involves close monitoring using a uterine artery doppler

17
Q

When do we consider early delivery of small gestational age babies?

A

When growth is static on the growth charts or other problems are identified

18
Q

What delivery method is used in small gestational age babies before 37 weeks gestation?

A

C-section

19
Q

What delivery method is used in small gestational age babies after 37 weeks gestation?

A

We offer labour induction with vaginal delivery

20
Q

What do we prescribe patients when delivery is considered between 24 and 36 weeks’ gestation (small for gestational age)? Why?

A

A single course of antenatal steroids should be given

This is to promote fetal lung growth, reducing the risk of respiratory distress syndrome

21
Q

What are the four short-term complications of small gestational babies?

A

Stillbirth

Neonatal Hypothermia

Neonatal Hypoglycaemia

Birth Asphyxia

22
Q

What are the four long-term complications of small gestational babies?

A

Type Two Diabetes

Obesity

Hypertension

Cancer

23
Q

What is large for gestational age (macrosomia)?

A

It is defined when the weight of the newborn is more than 4.5kg at birth

During pregnancy, an estimated fetal weight above the 90th centile is large

24
Q

What are the four causes of large gestational age?

A

Constitutionally Large

Maternal Diabetes

Overdue Baby

Maternal Obesity

25
Q

What two investigations are used to diagnose large gestational age?

A

Ultrasound Scan (same as small gestational age)

Oral Glucose Tolerance Test

26
Q

What is an oral glucose tolerance test used to diagnose large for gestational age?

A

To identify a potential underlying cause for macrosomia – gestational diabetes

27
Q

How do we deliver large gestational age babies?

A

Normal vaginal delivery

28
Q

What is the main complication of delivery of large gestational babies? How do we reduce this risk?

A

Shoulder dystocia

Delivery is conducted on a consultant lead unit and the third stage of labour is managed actively

29
Q

What are the four maternal complications of large gestational age?

A

Shoulder Dystocia

Failure to Progress

Perineal Tears

Postpartum Haemorrhage

30
Q

What are the four fetal complications of large gestational age?

A

Birth Injury

Neonatal Hypoglycaemia

Obesity

Type Two Diabetes

Year Three - Reproductive System (52 decks)

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