IUGR Flashcards
Small for gestational age (SGA)
Growth problem where fetus is below 5th centile.
This is due to normal variation or growth restriction
Intra-uterine growth restriction IUGR
Growth below 5th centile
Definitely due to growth restriction.
Causes of fetal growth restriction
Deficient plancental invasion
- Trophoblast invasion
Reduced placental reserve
When fetal needs exceeds supply
Consequences of fetal growth restriction
Hypoxia
Oliguria
Fetal death
CV problems
Fetal vasuclar redistribution
- Blood supply adapted towards the brain
- Due to placenta insufficiency
Diagnosing fetal growth restriction
Uterine size
- Symphysis-fundal height
Ultrasound
Symmetrical fetal growth restriction
When the head and abdominal cirumference growth are both restriction.
Causes
- Chromosomal abnormality
- Viral infection
- Severe placental insufficiency
- Small baby
Asymmetrical fetal growth restriction
Only when the abdominal growth is restricted
- Reflects fetal
liver size
Causes
- Placental insufficiency–> no excess glycogen
Hypoxia in fetus
Blood flow redirected to brain away from areas 'less important' - Gut - Kidney - Lungs
Ultrasound finding in IUGR
Small AC
Decreased amniotic fluid
- Kidney problem
Increased blood flow to brain
- Doppler
Clinical features of IUGR
Low Symphysis-fundal height
Reduced fetal movements
Change in fetal heart rate
Fetal death
When to delay delivery for IUGR
When fetus has low survival chances
When steroids need to be given
It reduces the need for C-section
When to deliver baby with IUGR
When past 32 weeks
When there is a doppler abnormality
Decreased fetal movements
CTG abnormality
Use of betamethasone/ dexamethasone
Stimulates aveoli cells to produce surfactant gene
- Stops collapse of aveoli by reducing surface tension
Prevent respiratory distress syndrome
Steroid is normally produced 24-34 weeks
