IUGR Flashcards
Complications
• Antepartum: Stillbirth Oligohydramnios
•Intrapartum: Fetal acidosis
•Neonatal Complications:
• Meconium aspiration syndrome
• Persistent fetal circulation
• Hypoxic-ischemic encephalopathy
• Hypoglycemia & Hypocalcemia
• Hyperviscosity syndrome
•Deficient temperature control
PHYSICAL FEATURES AT BIRTH :
• Weight 600 gm below the minimum in percentile standard
• Length is unaffected
• Head circumference is relatively larger in asymmetric variety
• Wrinkled skin
• Scaphoid abdomen
• Thin meconium-stained vernix caseosa.
• Thin umbilical cord.
• Plantar creases are well developed.
• The baby is alert ,active with normal cry.
• Reflexes are normal.
INTRAPARTUM MANAGEMENT
•INDICATIONS FOR LSCS:
• Fetal distress
• Malpresentation
• Very low fetal weight
• Failed induction
• Arrest of progress
• Previous cesarean section
INTRAPARTUM MANAGEMENT
INTRAPARTUM MONITORING
CTG
Sculp blood sample.
INTRAPARTUM MANAGEMENT
CARE DURING VAGINAL DELIVERY
• Delivery in equipped hospital
• Intensive intranatal monitoring
• Facility for intensive neonatal care
• In –Utero transfer of baby to equipped hospital.
DIAGNOSIS
- Previous medical or obstetric problems.
- Prior delivery of an IUGR baby.
- WEIGHT GAIN Not a reliable indicator.
- UTERINE FUNDAL HEIGHT. Stationary or may fall
- FETAL KICK COUNT
Diminished fetal movement - Ultrasound biometry is the gold standard for assessment of fetal size
and the amount of amniotic fluid. - lag in fundal height of 4 cm or more suggests IUGR.
MANAGEMENT TERMINATION OF PREGNANCY
Beyond 37 weeks :Termination of pregnancy should be done
•Before 37 weeks :Uncomplicated mild IUGR
•Treatment to improve placental function
•Severe degree of IUGRA
•attained lung maturity –Terminate pregnancy
•Not attained lung maturity –Dexamethasone therapy
ANTEPARTUM EVALUATION
• Clinical examination
• USG
• Fetal kick counts
• Doppler velocimetry
• NST
• Cord blood for blood gas analysis
