Growth Disorders

Question 1

the mortality rate of SGA

neonates born at 38 weeks

Answer 1

was 1 percent compared with 0.2 percent in those with

appropriate birthweights.

Question 2

70 percent of such SGA infants have normal
outcomes and are thought to be appropriately grown when maternal ethnic group,
parity, weight, and height are considered

Answer 2

Importantly, many neonates with birthweights <10th percentile are not
pathologically growth restricted, but instead are small simply because of normal
biological factors.

Question 3

Usher and McLean (1969) suggested that fetal growth standards should be based on mean
weights-for-age, with normal limits defined by ±2 standard deviations.

Answer 3

This

definition would limit SGA infants to 3 percent of births instead of 10 percent.

Question 4

brain-sparing

Answer 4

the ratio of brain weight to liver weight during the

last 12 weeks—usually about 3 to 1—may be increased to 5 to 1 or more in severely growth-restricted infants.

Question 5

Roza and associates (2008) found that fetuses with circulatory redistribution—brain sparing—had a
higher incidence of later behavioral problems.

Answer 5

In another study, evidence of brain sparing was found in half of 62 growth-restricted fetuses with birthweights <10th percentile and who showed abnormal middle cerebral artery Doppler flow studies

Question 6

what do you know about atrial natriuretic peptide converting enzyme, also known as corin?

Answer 6

plays a critical role in trophoblastic invasion and remodeling of the uterine spiral arteries (Cui, 2012). These processes are impaired in corin-deficient
mice, which also develop evidence of preeclampsia. Moreover, mutations in the gene for corin have been reported in women with preeclampsia.

Question 7

Management of FGR in anatomically normal fetus before 34 wks + AFI and fetal surveillance are normal :

Answer 7

Observation till fetal lung maturity is reached
Reassessment of fetal growth every 3-4 wks and weekly assessment of UAD velocimetry and amniotic fluid volume combined with non-stress testing

Question 8

Management recommendations based on Doppler studies are to consider delivery:

Answer 8

with absent flow at or beyond 34 weeks of gestation; with reversed flow at or beyond 32 weeks of gestation; and at greater than 37 weeks of gestation with decreased diastole flow.

Question 9

The primary autoantibody that predicts obstetrical

antiphospholipid syndrome appears to be

Answer 9

lupus anticoagulant (Yelnik, 2016).

Question 10

the most common infection related to FGR

Answer 10

Malaria infection

Question 11

Conditions associated with chronic hypoxia include asthma, maternal cyanotic heart disease, other chronic pulmonary disease, cigarette smoking, and living at high altitude as risk factors of FGR. For each 1000-meter rise in altitude, the birthweight declined — ?

Answer 11

For each 1000-meter rise in altitude, the birthweight declined 150 g

Question 12

Among antiphospholipid antibodies ——- anti-body may have a stronger association with FGR, particularly early-onset disease.

Answer 12

anti-β2 glycoprotein-I antibodies may have a stronger association with FGR, particularly early-onset disease.

Question 13

The stillbirth risk in the setting of absent and reversed end-diastolic flow is – percent and – percent, respectively (Caradeux, 2018)

Answer 13

The stillbirth risk in the setting of absent and reversed end-diastolic flow is 7 percent and 19 percent, respectively (Caradeux, 2018)

Question 14

Doppler abnormalities of the ductus venosu reflect increased central venous pressure from decreased cardiac compliance and higher right ventricular end-diastolic pressure. Fetuses with abnormal ductus venosus Doppler flow have a —percent risk for stillbirth, and this increases to – percent in cases with a reversed Awave (Caradeux, 2018).

Answer 14

Doppler abnormalities of the ductus venosus reflect increased central venous pressure from decreased cardiac compliance and higher right ventricular end-diastolic pressure. Fetuses with abnormal ductus venosus Doppler flow have a 20-percent risk for stillbirth, and this increases to 46 percent in cases with a reversed Awave (Caradeux, 2018).

Question 15

The stillbirth risk in the setting of absent and reversed end-diastolic flow is – percent and – percent, respectively (Caradeux, 2018).

Answer 15

The stillbirth risk in the setting of absent and reversed end-diastolic flow is 7 percent and 19 percent, respectively (Caradeux, 2018).

Question 16

Fetuses with abnormal ductus venosus Doppler flow have a —percent risk for stillbirth, and this increases to – percent in cases with a reversed Awave

Answer 16

Fetuses with abnormal ductus venosus Doppler flow have a 20-percent risk for stillbirth, and this increases to 46 percent in cases with a reversed Awave