IUGR: Intrauterine Growth Restriction: Causes, Diagnosis, Long term effects: Brocato Flashcards
What is the definition of IUGR?
Less than 10th percentile than estimated normal
TEST? What is the etiology of IUGR?
Extrinsic and Intrinsic causes: see below
TEST? What is the diagnosis of IUGR?
Ultrasound
Fundal height for screening
Risk factors
What is the management/timing of delivery in IUGR?
x
TEST? What are the immediate and long term sequelae of IUGR?
x
What goes up as fetal size goes down?
Morbidity
Mortality
What are extrinsic (maternal) risk for IUGR?
HTN Renal dz COPD Diabetes Collagen dz Hemoglobinopathies Smoking Malnutrition Infections
What are the intrinsic risk factors of IUGR?
Aneuploidy Genetic syndromes Congenital anomalies Placental disease Multiple gestation
What is the highest contributor to IUGR?
Maternal vascular disease
diabetes
lupus
htn
etc...What happens in maternal vascular disease?
Decrease IU perfusion
HTN/PREClampsia
What are the infections causing IUGR?
TORCHES
What is oligohydramnios?
Low amniotic fluid: <5 cm
What happens in oligohydramnios to cause IUGR?
Chronic hypoxia diverts blood from kidneys to vital organs, less fluid made
increased risk of mortality
normal fluid less likely to end in demise
What do doppler indices reflect?
Umbilical artery
Middle cerebral artery
Venous circulation
Uterine arteris
What direction does blood move in umbilical artery? vein?
Artery: blood going from baby to placenta (no O2)
Vein: Blood going to baby from placenta (high O2)
What does doppler ultrasound help us determine?
How hard it is to get blood into and out of placenta (vascular resistance)
When are uterine artery flow measured?
Preecclampsia
CHTN
What arteries are measured on doppler?
Umbilical artery
Middle cerebral artery
What veins are measured in doppler?
Umbilical vein Ductus venosus (shunt away from lungs to aorta from pulmonic artery)
What is typical of HTN dopplar?
Retrograde flow in veins and arteries: FLOW SHOULD ONLY GO FORWARD!!!! Systole and diastole too.
What is the most important nutrient for fetus?
Oxygen
If you are not oxygenated, what happens?
Acidosis: organ failure
How do you determine a IUGR delivery?
Case to case basis
What does IUGR baby become after birth?
SGH: “small for gestational age”
Big baby buzzword?
Gestational diabetes
Diabetes in general
