Intrauterine Programming of Adult Disease Flashcards
What are the human pregnancy complications?
preterm labour, pre eclampsia, intrauterine growth restriction, bleeding, anaemia, coagulation, maternal diseases, heart disease, renal disease, diabetes mellitus, convulsions, breech, intrauterine fetal death
What is preterm labour?
labour before 37 weeks gestation
What percentage of deliveries are preterm?
5-8%
What percentage of fetal morbidity and mortality is due to preterm labour?
80%
What are some causes of preterm labour?
ascending infection, premature rupture of membranes, multiple pregnancies, polyhydramnios (excess amniotic fluid)
What is the management for preterm labour?
steroids to mature the fetal lungs as quickly as possible
What is pre-eclampsia?
high maternal blood pressure, proteinuria, generalised oedema, placental dysfunction and intrauterine growth restrictions
What is eclampsia?
convulsions and coma in pregnancy
What percentage of maternal mortality is due to pre-eclampsia?
15%
What is though to be involved in the development of pre eclampsia?
abnormal placentation
What is the treatment for pre eclampsia?
delivery
What is the definition of intrauterine growth restriction?
birth weight for gestational age is less than 2 standard deviations below the population mean
What is the cause of intrauterine growth restriction?
placental insufficiency, multiple pregnancies, malformations, oligohydramnios, fetal infection, maternal diseases, pre-eclampsia, exercise, oxygen deprivation, maternal smoking, malnutrition or unknown
What does low birth weight predispose to?
adult disease and perinatal mortality
What factors control fetal growth?
genetics, the mother, the placenta, hormones and fetal hormones and growth factors
Which hormones promote fetal growth?
IGFs, thyroid hormone and insulin
Which hormones inhibit fetal growth?
glucocorticoids
Why are babies born at high altitude smaller?
because of the oxygen deprivation
Why are pregnant women advised not to use saunas?
because hyperthermia will restrict fetal growth
Why is excessive exercise in pregnant women not advised?
because it will redirect blood from placental circulation to the muscles and will restrict fetal growth
What causes oligohydramnios?
when the fetal lungs and kidneys arent producing enough fluid - this will result in slow organ development
What is the major cause of intrauterine growth restriction in the western world?
placental insufficiency
What is the major cause of intrauterine growth restriction in the third world?
maternal undernutrition
What is fetal programming?
Exposure of the fetus to a suboptimal environment causes adaptations that may help the fetus to survive in the short term but leads to increased susceptibility of developing some diseases in adulthood
