Intrauterine Growth Restriction Flashcards
What is intrauterine growth restriction (IUGR)?
intrauterine growth restriction refers to a fetus that has not reached its genetic growth potential due to pathological factors, resulting in a birth weight below the 10th centile for gestational age.
How is intrauterine growth restriction different from small for gestational age (SGA)?
intrauterine growth restriction implies growth restriction due to a pathological cause, while SGA describes a fetus that is small but may be healthy.
What are the types of intrauterine growth restriction?
Types include symmetrical intrauterine growth restriction (proportional growth restriction) and asymmetrical intrauterine growth restriction (disproportionate growth restriction).
What are the causes of symmetrical intrauterine growth restriction?
Causes include chromosomal abnormalities, congenital infections (e.g., TORCH infections), and genetic syndromes.
What are the causes of asymmetrical intrauterine growth restriction?
Causes include placental insufficiency, maternal hypertension, pre-eclampsia, and smoking.
What are the maternal risk factors for intrauterine growth restriction?
Risk factors include chronic hypertension, diabetes, smoking, malnutrition, multiple pregnancies, and uterine abnormalities.
What are the placental causes of intrauterine growth restriction?
Placental causes include placental insufficiency, abruption, infarction, and abnormal implantation such as placenta praevia.
What are the fetal risk factors for intrauterine growth restriction?
Fetal risk factors include chromosomal abnormalities, congenital malformations, and intrauterine infections.
How is intrauterine growth restriction diagnosed?
Diagnosis is made through serial growth ultrasounds, Doppler studies, and clinical assessment of symphysis-fundal height.
What are the clinical signs of intrauterine growth restriction?
Signs include reduced symphysis-fundal height, decreased fetal movements, and abnormal fetal heart rate patterns on CTG.
What ultrasound findings suggest intrauterine growth restriction?
Findings include reduced estimated fetal weight, small abdominal circumference, oligohydramnios, and abnormal Doppler studies.
What is the role of Doppler studies in intrauterine growth restriction?
Doppler studies assess blood flow in the umbilical artery, middle cerebral artery, and ductus venosus to evaluate placental and fetal health.
What is the significance of abnormal umbilical artery Doppler in intrauterine growth restriction?
Absent or reversed end-diastolic flow indicates severe placental insufficiency and increased risk of fetal compromise.
What are the complications of intrauterine growth restriction for the fetus?
Complications include stillbirth, hypoxia, neonatal hypoglycaemia, hypothermia, and long-term neurodevelopmental delays.
What are the complications of intrauterine growth restriction for the mother?
Complications include increased risk of pre-eclampsia, placental abruption, and operative delivery.
How is intrauterine growth restriction managed antenatally?
Management includes regular growth monitoring, Doppler studies, maternal lifestyle modifications, and corticosteroids if preterm delivery is anticipated.
When is delivery indicated in intrauterine growth restriction?
Delivery is indicated for severe intrauterine growth restriction, abnormal Doppler studies, maternal complications, or evidence of fetal compromise.
What is the preferred mode of delivery in intrauterine growth restriction?
Mode of delivery depends on the severity of growth restriction and fetal condition; caesarean section may be required for fetal compromise.
What lifestyle changes can help reduce the risk of intrauterine growth restriction?
Smoking cessation, balanced maternal nutrition, and management of chronic conditions like hypertension and diabetes.
What are the long-term outcomes for infants with intrauterine growth restriction?
Long-term outcomes may include developmental delays, learning difficulties, and increased risk of cardiovascular disease and diabetes.
How is neonatal hypoglycaemia managed in intrauterine growth restriction infants?
Management includes early and frequent feeding, blood glucose monitoring, and intravenous glucose if necessary.
What are the differential diagnoses for intrauterine growth restriction?
Differential diagnoses include SGA due to constitutional factors, oligohydramnios, and fetal structural anomalies.
What is the role of corticosteroids in intrauterine growth restriction?
Corticosteroids are given to enhance fetal lung maturity if preterm delivery is likely.
How can maternal infections contribute to intrauterine growth restriction?
Infections like cytomegalovirus or toxoplasmosis can impair placental function or directly affect fetal growth.
What is the importance of antenatal counselling in intrauterine growth restriction?
Counselling helps parents understand the diagnosis, management options, and potential outcomes for the baby.
How is intrauterine growth restriction monitored during pregnancy?
Monitoring includes serial ultrasounds, Doppler studies, fetal movement assessment, and cardiotocography (CTG) for fetal wellbeing.
What psychological support might be needed for parents of intrauterine growth restriction infants?
Support includes counselling for anxiety, fear, or grief and providing information about neonatal care and long-term outcomes.
