Intrauterine Growth Restriction

Question 0

Clinical

Answer 0

Poor fundal height growth
Poor weight gain 
Dec movement 
Inc MSAFP
Maternal complications

Question 1

IUGR

Answer 1

Born < 2500g or 5 lbs 8 oz term
Assoc with pathology
EFW < or = 10% and or poor growth over 2 or more exams.

Question 2

Risks

Answer 2

Previous IUGR fetus
Maternal HTN 
Smoking
Uterine anomalies
Placental hemorrhage

Question 3

IUGR

Answer 3

Born < 2500g or 5 lbs 8 oz term
Assoc with pathology
EFW < or = 10% and or poor growth over 2 or more exams.

Question 4

Clinical

Answer 4

Poor fundal height growth
Poor weight gain 
Dec movement 
Inc MSAFP
Maternal complications

Question 5

Risks

Answer 5

Previous IUGR fetus
Maternal HTN 
Smoking
Uterine anomalies
Placental hemorrhage

Question 6

Asymmetric IUGR

Answer 6

MC
Seen in last 8-10 weeks of pregnancy
Reduction in cell size not cell number
Brain sparing

Cause: placenta insufficiency, diabetes, HTN, ❤️ disease, renal disease, abruption, twins, smoking, poor weight gain, drugs, uterine anomalies

Abnl HC/AC ratio, oligohydramnios, grade 3 pl < 36 wks, abnl umb art Doppler

Question 7

Symmetric IUGR

Answer 7

Early in pregnancy
Reduction in cell size and number
Small head and abd

Causes: 50% ideopathic, insult in 1st tri, genetic, chromosomal, congenital, chronic fetal infection, alcohol, maternal disease, poor nutrition, high altitude irradiation

HC/AC not useful, must know exact EDD, oligohydramnios, grade 3 pl < 36 wks, abnl umb art Doppler

Question 8

Oligohydramnios

Answer 8

AFI < 5cm
Single pocket < 2 cm

Assoc IUGR, PROM, renal anomalies, post dates

Question 9

Umbilical Artery Doppler in IUGR

Answer 9

Absent/reversed flow
S/D ratio > 3 after 30 wks is abnl. Inc resistance.
S/D ratio > 2.6 in ut artery is abnl

Umb vein pulsatility. Late finding

Question 10

Macrosomia

Answer 10

Fetal weight > 90%

Assoc with diabetes