INTRAUTERINE GROWTH RESTRICTION

Question 1

IUGR

Answer 1

*a fetus with estimated fetal weight (EFW) <10th percentile for gestational age

*Or its weight <2,500 grams

Question 2

fetal causes of IUGR :

Answer 2

1) aneuploidy (T21/T18/T13)
2) infection (e.g., TORCH)
3) structural anomalies

**symmetrical IUGR
**workup should be include detailed sonogram, karyotype, and screen for fetal infections.

Question 3

Placental Causes of IUGR

Answer 3

*abnormal implantation or insertion of the cord, preeclampsia, placental insufficiency
**Asymmetrical IUGR
**head sparing,small abdomen

Question 4

Maternal Causes of IUGR

Answer 4

chronic disease such as diabetes and HTN , systemic lupus erythematosus, or cyanotic heart disease; smoking; abnormal uterine anatomy; low pregnancy weight gain,
immunosuppressive drugs (eg, cyclosporine, azathioprine, corticosteroids) and chemotherapy

Question 5

monitoring in case of IUGR

Answer 5

*serial growth sonograms
*Weekly Biophysical profile
*umbilical artery Dopplers

Question 6

biophysical profile components :

Answer 6

*nonstress test
*amniotic fluid volume ->5
*fetal movement->3
*fetal tone >1 episode
*fetal breathing movements >1 episode for >30 second

maximal score - 10
abnormal =0
2 points for each normal component

***perform continuous observation for >30 minutes

***BATMAN -
Breathing ,Amniotic fluid,Tone,Movement ,Nonstress test

Question 7

Amniotic fluid index (AFI):

Answer 7

Oligohydramnios: <5 cm
– Normal: 5–24 cm
– Polyhydramnios: >25 cm

Question 8

Umbilibal artery doppler :

Answer 8

Systolic ratio over Diastolic كل ما كانت اعلى كل ما كان في resistance اكبر EDV vs Peak systolic volume.

Question 9

fetal alcohol syndrome

Answer 9

Major features of fetal alcohol syndrome are growth restriction, craniofacial dysmorphism like microcephaly or microphthalmia, intellectual retardation, cardiac defects, and behavioral discrepancies