Growth Restriction Flashcards
Risk of recurrence of SGA if happened in previous pregnancy?
20%
Delivery of FGR > 3%ile w/ normal dopplers?
38w0d-39w0d
Delivery of severe IUGR (< 3%ile) w/ normal dopplers?
37w0d
Delivery w/ dopplers decreased end diastolic flow
37w0d
Delivery w/ dopplers absent end diastolic flow?
33w0d-34w0d
Delivery w/ dopplers reversed end diastolic flow
30w0d-32w0
Maternal nutrition associated with FGR?
Only if poor protein intake or severe calorie restriction before 26 weeks
What is the approximate risk of stillbirth in a fetus with EFW < 10th% for GA?
1.5%
Normal growth 0.75%
(EFW < 5%ile 2.5%)
Define fetal growth restriction
EFW or abdominal circumference < 10%ile
Define SGA
Birth Weight < 10%ile for gestational age
DETERMINED AFTER BIRTH
Maternal Causes of FGR
PREgestational DM
Autoimmune Disease
Cyanotic congenital heart disease
Hypertensive Disorders
APS
Tobacco/Alcohol
Illicit Substance Use
Multiple Gestations
Infections (TORC, syphilis, varicella and malaria)
Fetal Causes of FGR
Genetic Disorders (Trisomy 13 or 18)
Congenital Malformations (gastroschisis, congenital heart disease)
Placental/Cord Causes of FGR
Placenta: abruption, infarction, circumvallate shape, hemangioma, and chorioangioma
Cord: velamentous, marginal cord
**All can cause placental insufficiency
Placenta accreta associated with IUGR
No
Placenta Previa associated with IUGR?
No
Single Umbilical Artery associated with IUGR?
No
Differential Diagnosis for small fetus?
- Fetal Growth Restriction (can be symmetric or asymmetric, will get worse as pregnancy grows)
- Constitutionally small fetus (always symmetric, maintains small growth)
- Incorrect gestational dating
How do you differentiate between a constitutionally small fetus and FGR?
Constitutionally small with is always symmetric and consistently stay at the same percentile throughout the pregnancy
FGR can be asymmetric, progressively will get worse during pregnancy
