Intrauterine Growth Retardation Flashcards
Maternal causes
Alcohol
Smoking
Cocaine
ACE inhibitors
Carbamezapin
Warfarin
Uteroplacental causes
Due to placental insufficiency
Caused by smoking , chronic high blood pressure , diabetes mellitus , anorexia , anemia , preeclampsia , RH incompatibility
Due to placenta previa
Due to multiple gestations
Fetal factors
Genetic abnormality
Cyanotic congitinal heat defects
TORCH
What are the 2 different types of IUGR ?
Asymmetrical and symmetrical
What does the asymmetrical IUGR mean ?
- caused by extrinsic factors
- due to maternal systemic disease like hypertension that will result in placental inssufiencey
What is the clinical features of asymmetrical IUGR ?
- small for gestational age
- decreased or absent fetal movement
- body and limbs smaller than head
- Decrease fundal height
- small uterus
- vaginal bleeding
What does symmetrical IUGR mean ?
Due to genetic disorders
- due to Anaploidy , conginital heart disease , early intrauterine TORCH infection that affects the fetus early in gestation
What are the clinical features of the symmetrical IUGR
- small for gestational age
- decreased or absent fetal movement
- entire body is small
- decreased fundal height
- small uterus
- vaginal bleeding
What is seen in ultrasound ?
- decrease fetal growth
- small placenta
- Oligohydramnios
What is seen in Doppler velocemitry of the umbilical artery ?
Reduced or reserved diastolic flow
What is seen on a non stress test ?
- late deceleration of fetal heart beat
- Bradycardia
What is seen in biophysical profile ?
- Oligohydramnios
- no fetal breathing movement
- decrease fetal movement and tone
- Placental insufficiency
Treatment
1) treat the underlying condition
2) monitor fetal status and placenta
3) induce labor or c section if no fetal status
4) if infant is less than 34 weeks , administer steroids and induce labor
What does uteroplacnetal insufficiency mean ?
- disorder of the fetomaaternal circulation
-causes adequate blood flow to the placenta - impaired substance exchange oxygen between the mother and the fetus
- leading to metabolic compromise of the fetus
What are the causes and risk factors of utero placental insufficiency ?
Maternal condition
- smoking during pregnancy
- DM with vasculopathy
-Chronic hypertension
- severe anemia
- anorexia nervous
- antiphospholipid syndrome
Preganancy related
- preeclampsia
- RH incompatibility
