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Obstetric And Gynecology > IUGR > Flashcards

IUGR Flashcards

1
Q

Define intrauterine growth restriction (IUGR).

A

Babies whose birth weight is below the 10th percentile for gestational age.

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2
Q

Fill in the blank: IUGR is diagnosed when birth weight is below the ______ percentile for gestational age.

A

10th.

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3
Q

Differentiate between mild and severe IUGR based on disparity in weeks.

A

Mild IUGR: disparity ≥ 2 weeks; severe IUGR: disparity ≥ 4 weeks.

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4
Q

What is the incidence of dysmaturity in low-birth-weight (LBW) babies?

A

About one-third.

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5
Q

Fill in the blank: Term babies have an IUGR incidence of ______%, while post-term babies have an incidence of ______%.

A

5%; 15%.

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6
Q

How does perinatal mortality correlate with birth weight percentile in IUGR?

A

Perinatal mortality increases as birth weight percentile decreases.

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7
Q

Explain the difference between SGA and IUGR.

A

SGA refers to small but healthy babies; IUGR involves growth restriction with increased perinatal risk.

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8
Q

Fill in the blank: Cellular hyperplasia dominates fetal growth up to ______ weeks.

A

16 weeks.

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9
Q

What are the three phases of fetal growth?

A

Cellular hyperplasia, hyperplasia and hypertrophy, hypertrophy.

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10
Q

Define symmetrical and asymmetrical IUGR.

A

Symmetrical: affects all organs; asymmetrical: affects body more than head.

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11
Q

Name a common cause of symmetrical IUGR.

A

Chromosomal abnormalities or congenital infections.

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12
Q

Fill in the blank: ______ maternal diseases often cause asymmetrical IUGR.

A

Extrinsic.

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13
Q

What is the role of uteroplacental flow in asymmetrical IUGR?

A

It alters fetal size by reducing oxygen and nutrient transfer.

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14
Q

What are the maternal constitutional factors contributing to IUGR?

A

Small women, low maternal weight, genetic/racial background.

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15
Q

List three maternal diseases that contribute to IUGR.

A

Anemia, hypertension, chronic renal disease.

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16
Q

Fill in the blank: ______ is a toxin that leads to placental thrombosis.

A

Antiphospholipid antibody syndrome.

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17
Q

Name two fetal structural anomalies associated with IUGR.

A

Cardiovascular and renal anomalies.

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18
Q

Which chromosomal abnormalities are common in IUGR cases?

A

Triploidy, aneuploidy, trisomies (13, 18, 21), Turner’s syndrome.

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19
Q

What is the role of TORCH infections in IUGR?

A

They cause direct cell damage and vascular insufficiency.

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20
Q

Fill in the blank: ______ malaria can lead to IUGR.

A

Falciparum.

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21
Q

What placental factors contribute to IUGR?

A

Poor uterine blood flow, placental insufficiency, placental abnormalities.

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22
Q

Define chronic placental insufficiency.

A

Inadequate placental nutrient transfer over time.

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23
Q

Fill in the blank: Placenta ______ is a condition that hinders proper substrate transfer to the fetus.

A

Praevia.

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24
Q

What percentage of IUGR cases have unknown causes?

A

40%.

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25
Q

Explain the pathophysiology of IUGR.

A

Reduced maternal nutrients, impaired placental transfer, and fetal underutilization.

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26
Q

What happens to fetal brain size in symmetric versus asymmetric IUGR?

A

Brain size reduced in both; more pronounced in symmetrical IUGR.

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27
Q

Fill in the blank: Reduced fetal liver glycogen content can lead to ______.

A

Hypoglycemia.

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28
Q

What is the role of accelerated fetal pulmonary maturation in IUGR?

A

Fetus accelerates lung development in response to stress.

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29
Q

Fill in the blank: Fetal ______ production increases in response to stress in IUGR pregnancies.

A

Cortisol.

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30
Q

How is IUGR diagnosed clinically?

A

Symphysis-fundal height, palpation, maternal weight gain.

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31
Q

Fill in the blank: A lag of ______ cm in symphysis-fundal height suggests IUGR.

A

4 cm.

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32
Q

What maternal weight changes indicate IUGR?

A

Stationary or falling weight in the second half of pregnancy.

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33
Q

What investigations are recommended for suspected IUGR?

A

Hemoglobin, blood group, urine tests, HIV screening, TSH, OGTT.

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34
Q

Fill in the blank: Abdominal circumference is the ______ diagnostic parameter for IUGR.

A

Most sensitive.

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35
Q

What is the significance of the head circumference to abdominal circumference ratio in IUGR?

A

Indicates type of IUGR (symmetrical vs. asymmetrical).

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36
Q

Fill in the blank: Amniotic fluid index (AFI) < ______ cm indicates oligohydramnios in IUGR.

A
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37
Q

What placental grading is associated with placental insufficiency?

A

Grade III.

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38
Q

Describe the Doppler findings in umbilical artery velocimetry in IUGR.

A

Reduced/absent/reversed diastolic flow indicates fetal jeopardy.

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39
Q

Fill in the blank: ______ flow in the middle cerebral artery suggests the brain-sparing effect in IUGR.

A

Increased diastolic flow.

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40
Q

What biochemical markers are elevated in IUGR?

A

Elevated MSAFP and hCG levels.

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41
Q

What are the physical features of a newborn with IUGR?

A

Weight deficit, larger head relative to body, dry/wrinkled skin, thin umbilical cord.

42
Q

Fill in the blank: IUGR newborns have a weight deficit of ______ grams below the minimum percentile.

A

600 grams.

43
Q

What is the “old man look” in IUGR newborns?

A

Thin, wrinkled appearance due to lack of subcutaneous fat.

44
Q

What are the immediate fetal complications of IUGR?

A

Chronic fetal distress, hypoxia, acidosis, meconium aspiration syndrome.

45
Q

Fill in the blank: Chronic hypoxia in IUGR leads to ______ amniotic fluid volume.

A

Diminished.

46
Q

Name two long-term complications of IUGR.

A

Neurological/intellectual delays, metabolic syndrome in adulthood.

47
Q

How does IUGR affect neurodevelopment in infancy?

A

Delayed cognitive and motor development.

48
Q

Fill in the blank: Adults born with IUGR have an increased risk of developing ______ syndrome.

A

Metabolic.

49
Q

What are the maternal risks associated with IUGR?

A

Underlying diseases like pre-eclampsia or malnutrition can be life-threatening.

50
Q

Describe the management protocol for mild IUGR.

A

Increased rest, monitoring, and dietary recommendations.

51
Q

Fill in the blank: Severe IUGR requires delivery before ______ weeks if fetal compromise is detected.

A
52
Q

What is the role of betamethasone therapy in IUGR management?

A

Promotes fetal lung maturation.

53
Q

Fill in the blank: Betamethasone reduces the risk of neonatal ______ and ______ in preterm IUGR.

A

HMD (hyaline membrane disease) and IVH (intraventricular hemorrhage).

54
Q

What are the indications for cesarean delivery in IUGR?

A

Fetal acidemia, reversed umbilical artery flow, or unfavorable cervix.

55
Q

Fill in the blank: ______ monitoring is essential during vaginal delivery of IUGR babies.

A

Continuous fetal monitoring.

56
Q

What are the risks during the second stage of labor for IUGR babies?

A

Asphyxia, delayed second-stage labor.

57
Q

Fill in the blank: Episiotomy in IUGR labor minimizes ______ compression.

A

Head.

58
Q

Describe fetal surveillance methods in IUGR.

A

Kick counts, NST, Doppler studies, biophysical profiles.

59
Q

Fill in the blank: Doppler studies of the ______ venosus assess fetal blood flow.

A

Ductus venosus.

60
Q

What is the significance of NST in IUGR?

A

Evaluates fetal heart rate and well-being.

61
Q

What is the first step in managing constitutionally small fetuses?

A

No intervention required unless complications arise.

62
Q

Fill in the blank: Maternal hyperoxygenation involves administering oxygen at ______ mL/min.

A

2.5 mL/min.

63
Q

How does low-dose aspirin benefit select IUGR pregnancies?

A

Reduces risks of thrombotic complications, hypertension, and preeclampsia.

64
Q

What general management measures are recommended for IUGR?

A

Bed rest, balanced diet, avoidance of smoking and alcohol.

65
Q

What factors determine the time of delivery in IUGR?

A

Fetal status, gestational age, degree of growth restriction.

66
Q

Fill in the blank: Delivery at ______ weeks is recommended for uncomplicated mild IUGR.

A
67
Q

What are the challenges of managing preterm IUGR?

A

Risk of prematurity and complications.

68
Q

Fill in the blank: NICU care is essential for ______ IUGR cases.

A

Severe.

69
Q

What are the indications for early termination in severe IUGR?

A

Severe growth restriction with fetal compromise.

70
Q

What is the significance of corticosteroid use in IUGR management?

A

Reduces neonatal respiratory complications.

71
Q

How is intrapartum fetal oxygenation ensured in IUGR labor?

A

Oxygen to the mother via mask, continuous monitoring.

72
Q

Fill in the blank: The presence of ______ in the amniotic fluid study indicates lung maturity in IUGR.

A

Phosphatidylglycerol.

73
Q

What monitoring tools are used during labor in IUGR pregnancies?

A

Continuous electronic monitoring, scalp blood sampling.

74
Q

Fill in the blank: Elevated ______ ratios in Doppler studies suggest impaired placentation in IUGR.

A

S/D (systolic/diastolic) ratios.

75
Q

What is the recommended position for maternal rest in IUGR management?

A

Left lateral.

76
Q

What dietary recommendations are made for IUGR management?

A

Balanced diet with 300 extra calories daily.

77
Q

Fill in the blank: Avoiding ______ and ______ can improve IUGR outcomes.

A

Smoking, alcohol.

78
Q

What are the management protocols for severe IUGR?

A

Intensive monitoring, potential early delivery.

79
Q

How does maternal anemia affect IUGR?

A

Causes hypoxia and reduces oxygen transfer.

80
Q

Fill in the blank: Congenital infections such as ______ are significant contributors to IUGR.

A

TORCH.

81
Q

What are the roles of PGE2 gel in IUGR labor?

A

Induces labor in unfavorable cervix conditions.

82
Q

Fill in the blank: Intrapartum ______ reduces asphyxia risk in IUGR babies.

A

Monitoring.

83
Q

How is fetal acidemia managed during IUGR labor?

A

Close monitoring, immediate delivery if necessary.

84
Q

Fill in the blank: ______ is a primary indicator for cesarean section in IUGR pregnancies.

A

Absent/reversed diastolic flow in umbilical artery Doppler.

85
Q

What is the significance of amniotic fluid volume monitoring in IUGR?

A

Detects oligohydramnios, fetal distress.

86
Q

Fill in the blank: ______ delivery minimizes head compression in IUGR labor.

A

Slow, gentle.

87
Q

How does delayed clamping of the umbilical cord affect IUGR?

A

Increases risk of hypovolemia in the newborn.

88
Q

What are the neonatal complications of IUGR?

A

Asphyxia, hypoglycemia, respiratory distress syndrome.

89
Q

Fill in the blank: Polycythemia in IUGR babies increases the risk of ______.

A

Thrombosis.

90
Q

Describe the management of electrolyte imbalances in IUGR newborns.

A

Correct fluid and electrolyte imbalances based on neonatal needs.

91
Q

Fill in the blank: Severe IUGR often requires in utero transfer to a ______ center.

A

Referral.

92
Q

What are the postnatal growth patterns in asymmetrical IUGR babies?

A

Catch-up growth in early infancy.

93
Q

Fill in the blank: Neurologic development is worst in IUGR cases with ______ abnormalities.

A

Chromosomal.

94
Q

What are the recommendations for antenatal biophysical profiles in IUGR?

A

To detect early signs of fetal distress or abnormalities.

95
Q

Fill in the blank: ______ fetal status on Doppler requires immediate delivery in IUGR.

A

Non-reassuring.

96
Q

What is the importance of early diagnosis of IUGR?

A

Enables timely interventions to prevent complications.

97
Q

Fill in the blank: Chromosomal abnormalities in IUGR include ______ syndrome.

A

Turner’s.

98
Q

How does social deprivation contribute to IUGR?

A

Poor nutrition, smoking, alcohol, and substance abuse.

99
Q

Fill in the blank: Placental ______ leads to insufficient nutrient transfer in IUGR.

A

Insufficiency.

100
Q

Summarize the goals of IUGR management.

A

Diagnose, monitor, and ensure optimal outcomes for mother and fetus.

Obstetric And Gynecology (26 decks)

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