IUGR

Question 1

IUGR

Answer 1

Manifestation of disease due to maternal, fetal, Placental problems.

Question 2

Criteria for IUGR

Answer 2

Weight of fetus : < 10 percentile for that gestational age

> 2 SD

Question 3

First change seen in IUGR

Answer 3

Abdominal circumference in fetus.

Question 4

Smoking _____ IUGR

Answer 4

Leads to IUGR

smoking leads to vasoconstriction which dec volume and substrates leading to IUGR

Question 5

Classification of IUGR

Answer 5

Type 1 and Type 2

Question 6

Type 1 IUGR

Answer 6

Early pregnancy
Symmetrical IUGR
Bad prognosis
All fetal parameters dec.- AC, BPD, FL, Wt, HC,
Ponderal index is normal
causes : Chronic anomaly, TORCH infection and genetic Dis

Question 7

Causes of Type 1 IUGR

Answer 7

Chronic chromosomal anomalies
TORCH infxn
Genetic diseases

Question 8

Type 2 IUGR

Answer 8

Late pregnancy.
Asymmetrical IUGR 
Good Prognosis.
seen btw 32-34 weeks 
Brain Sparing effect is seen
AC and Wt - dec 
HC, BPD, FL remain normal.
Ponderal index = dec.
Causes Placental insufficiency 
PIH 
chronic renal disease

Question 9

causes of Type 2 IUGR

Answer 9

Chronic renal disease
PIH
Placental Insufficiency

Question 10

Ponderal Index

Answer 10

Est Fetal weight / (FL) 3

Question 11

Maternal causes of IUGR

Answer 11

PIH 
Placental insufficiency 
Heart disease - NYHA 3 and 4
Connective tissue disorder
Infection
Diabetes with Vasculopathy 
Diabetes with PIH

Question 12

Only conditions of diabetes where IUGR is found

Answer 12

D + Vasculopathy / PIH

Question 13

Placental causes of IUGR

Answer 13

Placental Insufficiency
Abnormal Placenta
Placental calcifications.

Question 14

Fetal causes of IUGR

Answer 14

Chronic anomaly
Genetic diseases
Infections.

Question 15

Maternal Risk factors for IUGR

Answer 15

PIH, Chronic renal disease , Low BMI and Wt gain during pregnancy, Infections.

Question 16

Clinical diagnosis of IUGR

Answer 16

Lag in Symphysio-Fundal height by 4cms.

On USG best parameter - AC

Question 17

Single best measurement of fetal growth

Answer 17

AC

Question 18

Plane for measuring AC

Answer 18

Plane with visible
F-Fetal stomach
U- Umbilical vein
P- Portal sinus

Question 19

Age independant ratio

Answer 19

HC/AC
in normal pregnancy This ratio dec as pregnancy advances
In IUGR - asymmetric - This increases

Question 20

Placental Morphology

Answer 20

Grade 0, 1, 2, 3.

Question 21

Grade 1 placenta -

Answer 21

randomly dispersed echogenic area

Question 22

Grade 2 placenta

Answer 22

comma shaped indentations on chorionic plate

Question 23

Distinct indentations and cotyledon formations are seen in grade ______ placenta

Answer 23

3

Question 24

Best war to assess IUGR

Answer 24

Doppler

Question 25

UA doppler findings in IUGR

Answer 25

S/D ratio is inc

Question 26

MCA Doppler findings in IUGR

Answer 26

S/D ratio is dec

Question 27

Complication in IUGR

Answer 27

Oligohydramnios leading to fetal distress leading to meconium aspiration syndrome
LBW
Fetal Distress - Hypoxia or acidosis
Stillbirth

Question 28

Fetal Surveillance in IUGR

Answer 28

Bi weekly NST

Question 29

Definite Mx of IUGR

Answer 29

Based on Doppler findings .
if UA doppler is normal - TOP at >38wks and continue NST biweekly
If UA doppler shows - S/D Dec - TOP @ 37wks .
If UA doppler shows - Absent flow - TOP @ 34 wks
If UA doppler shows - Reversed flow - immediate TOP