IUGR

Question 1

Ix ?IUGR

Answer 1

SFH
USS
Auscultation
BP+urine
?TORCH
Consultant obs. clinic
Growth scans
UA doppler
CTG

Question 2

Detection of SGA depends on:

Answer 2

Accurate age assessment

recognition of smallness

Question 3

Method of confirming gestational age

Answer 3

<13+6 CRL

13+6-20 HC

Question 4

Most precise way of confirming GA

Answer 4

ultrasound biometry

• biparietal diameter
• HC
• AC
• FL

Question 5

Once SGA diagnosed

Answer 5

is foetus constitutionally small or is this FGR

Question 6

Rx for uteroplacental insufficiency

Answer 6

no accepted
stop smoking, alcohol, drugs
Low dose aspirin may work but nothing established

Question 7

Monitoring for confirmed SGA

Answer 7

AC, HC, FL
Serial growth scans every 2wk
Doppler UA 2 per wk
Advise mothers to monitor foetal movement and perform CTG if reduced

Question 8

Indications for immediate delivery in SGA

Answer 8

Abmormal CTG (red. FM)
Reversal of ED flow

Question 9

Delivery in SGA

Answer 9

by 37 wks usually necessary

give steroids <36wks

Question 10

PACES Counselling of SGA

Answer 10

RF: low mat. BMI, chromosomal an., drugs, placental insufficiency, multiple pregnancy, oligohydramnios
Consider admission esp. if RFM
Explain will be regularly monitored and why
Explain IUGR (slow growth ?placenta)
May req. early delivery but ideally as late as possible
Advise monitor foetal movements closely
Prepare to discuss delivery plans