Intrauterine growth and growth restriction

Question 1

What is the definition of fetal growth restriction?

Answer 1

Difficult to define - a conceptual definition. It is a condition in which a fetus does not achieve its optimal potential of growth.

Question 2

True or false: If a fetus is not small, it is not growth restricted.

Answer 2

False. Not all small fetuses are growth restricted, and all growth restricted fetuses are not small.

Question 3

What are causes of a fetus being small for gestational age (SGA)?

Answer 3

Dating problems.
Normal variant.
Environmental/fetal problems.
Placental insufficiency.

Question 4

What are maternal risk factors for having a fetus that is SGA?

Answer 4

Past history.
Medical problems, such as sickle cell disease.
Exposure to teratogens.
Constitutional.
Dating errors.

Question 5

What are fetal risk for SGA?

Answer 5

Multiple pregnancy.
Aneuploidy.
Structural abnormality.
Genetic syndromes.
Fetal infections.

Question 6

What are methods of detecting fetal growth restriction?

Answer 6

Measuring symphysis-fundal height (SFH).
Serial Ultrasound biometry.
Uterine artery Doppler screening.

Question 7

What characterizes preterm intrauterine growth restriction?

Answer 7

Diagnosis, fetal response and monitoring is well characterized.
Pathophysiology and natural history is understood.

Question 8

What are potential impacts of “smallness” in fetuses?

Answer 8

Small fetuses often remain small later in life.
Morbidity linked to smallness.
Higher rates of cerebral palsy.
Genetic imprinting – genetic basis of adult disease.