IUGD Flashcards
Define IUGR
Failure of fetus to achieve the expected weight for a given gestational age
Define small for gestational age
Birth weight is below the 10th percentile for the given population
Maternal causes of IUGR x5
Substance abuse
Teratogenic drugs
Systemic diseases resulting in placental insufficiency
Infections
Malnutrition
Effect of ACE inhibitors on the fetus x4
Oligohydramnios
Pulmonary hypoplasia
Prolonged hypotension
Neonatal death
Uteroplacental causes of IUGR X5
Placenta previa
Placenta abruption
Multiple gestation
Uterine malformation
Umbilical cord abnormalities
Fetal causes of IUGR x3
Infections
Multiple gestation
Cyanotic congenital heart disease
3 umbilical cord abnormalities in IUGR
Short cord syndrome
Single umbilical artery
Marginal cord insertion
3 differences between symmetric and asymmetric IUGR
Symmetric- early onset injury, caused by intrinsic factors, proportionately small body
Asymmetric- late onset injury, caused by extrinsic factors, undernutrition with growth compensation in vital organs
Sequence of diminished fetal growth x3
Subcutaneous tissue
Axial skeleton
Vital organs
Pathophysiology of IUGR x3
Compromised uteroplacental blood flow>
Insufficient transplacental delivery of oxygen and nutrients and
Decreased removal of waste products
Investigations for IUGR X4
Abdominal USS
VDRL
Fetal karyotpe
Screen for thrombophilia
Umbilical artery doppler velocimetry
Severe IUGR management
NST/BPP twice a week
Non stress test, biophysical profile
Management of mild to moderate IUGR x4
Daily fetal kicks count
Weekly ANC visits
Weekly NST/BPP
Serial USS- track growth
IUGR management before 34wks x3 after 34wks x1
IUGR <34weeks- corticosteroids, regular fetal monitoring, deliver at 34 weeks
IUGR >34weeks- immediate delivery
Complications of compromised uteroplacental insufficiency x3
Hypoxia
Acidosis
Death
