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Obstetrics > Inadequate fundal growth > Flashcards

Inadequate fundal growth Flashcards

1
Q

What is the definition of inadequate fundal growth?

A

A SF measurement below the 10th per centile for gestation at >2 antenatal visits

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2
Q

What are the causes of inadequate fundal growth?

A
  1. Wrong dates
  2. Oligohydroamnios
  3. Abnormal lie
  4. Small baby
  5. Intra-uterine death
  6. Fetal abnormalities
  7. Intra-uterine growth restriction
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3
Q

What is IUGR?

A

A baby not growing to its full genetic potential usually due to placental insufficiency

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4
Q

What is a preterm baby?

A

A baby born before 37 weeks gestational age

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5
Q

What is a small for gestational age baby?

A

This is a baby born at a birth weight less than

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6
Q

What is a low birth weight baby?

A

A baby that has a birth weight below the tenth percentile for gestational age
Developed countries: 2500g
Developing countries: <2000g or even 1500g

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7
Q

What are the features of symmetrical IUGR?

A
  • Occurs early in the pregnancy
  • the fetal head and the abdomen are the same(according to bi-parietal diamter or head circumference)
  • the cause is usually chromosomal abnormalities, intra-uterine infection, and placental insufficiency
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8
Q

What are the features of asymmetrical IUGR?

A
  • Occurs after 20 weeks

- the fetal head is bigger than the abdomen

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9
Q

What do we do with babies that are constitutionally small for age?

A

We need to let them spontaneously grow and go into spontaneous labour

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10
Q

What are the fetal causes of inadequate fundal growth?

A
  1. Congenital infections-syphillis, rubella, cytomegalovirus, hep A,B, toxoplasmosis
  2. Congenital abnormalities-trisomies
    3.
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11
Q

When we see Inadequate fundal growth what must we think of immediately?

A

Syphillis

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12
Q

What are the placental causes of inadequate fundal growth?

A
  1. Smoker

2.

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13
Q

What are maternal causes of inadequate fundal growth?

A
  1. Smoker
  2. Malnutrition
  3. Decreased socio-economic status
  4. Alcohol
  5. Strenuous worker
  6. Pre-eclampsia and chronic hypertensive patients
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14
Q

How do we diagnose decreased SF height ?

A
  1. If there are two consecutive values below the 10th percentile
  2. Three values that form a plateau
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15
Q

What is the approach to a patient with inadequate fundal growth?

A
  1. Ascertain the correct gestational age
  2. Confirm the presence of a fetal heart beat
  3. Examine the abdomen for clinical signs of IUGR
  4. Assess the cervix
  5. Clinical exam of the mother to assess possible HPT
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16
Q

What should we do if we suspect IUGR but not sure?

A

-Do a doppler to asses umbilical blood flow
If there’s no doppler then do an ultrasound scan
-if these are normal then proceed to term

17
Q

What are the special investigations to assess placental function or diagnose IUGR?

A
  1. Doppler velocimetry
  2. Antepartum fetal heart rate monitoring
  3. Count fetal movements
  4. Assess amniotic fluid volume (ultrasound)
18
Q

What should we do if we find on doppler and ultrasound that the placental function is normal?

A
  1. Proceed with the pregnancy until term
19
Q

What should we do if we find that the placental function is abnormal?

A

Terminate the pregnancy

20
Q

What should we if the placental function is doubtful >36 weeks

A

Deliver the fetus

21
Q

What should we do if the placental function is doubtful l and <36 weeks?

A

Assess every 2-3 days and then terminate if it gets worse

22
Q

What are the complications associated with IUGR in babies?

A
  1. Hypothermia
  2. Hypoglycemia
  3. Respiratory infection
  4. Hypocalcaemia

Obstetrics (18 decks)

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