IUGR/SFD/FGR Flashcards
Define SFD
Fetus <10th centile for estimated fetal weight for their gestation. Not all SFDs = IUGR
Define IUGR/FGR
Failure of the fetus to reach its growth potential due to a pathological process. Fetus <10th centile for estimated fetal weight for their gestation
Two types of SFD or IUGR
Symmetrical and asymmetrical
What is symmetrical vs asymmetrical
Head + body are proportionally small and irreversible and occurs earlier in pregnancy in symmetrical whereas asymmetrical the head is normal but body and limbs are small. Usually occurs in 3rd trimester and is reversible
Causes of symmetrical SFDs
Constitutional
Congenital
Chromosomal
Causes of asymmetrical SFDs
'’Placenta is a SCAAAAAM’’
Placental insufficiency - PET/PIH
Smoking
Chronic disease - IBD/Diabetes
Coag disease - thrombophilia
AAAA - Anemia, Alcohol, APS
Malnutrition
Management of asymmetrical SFDs
Admit
Stockings + LMWH
Monitor on CTG and US
Delivery plan: 34/40 minimum, ideally 36-37/40
Give steroids up to 36-39/40
MgSo4 for delivery <32/40 (neuroprotection)
Send placenta to lab + blood gases
Management of symmetrical SFDs
O/E - Check fundal height, presentation, MOD
Investigate in ANC: FBC, G&H
CTG - Detect hypoxia
US
Fetal anatomy scan
Differential for SFDs
Small baby
Small mother
Wrong dates
ROM
Oligohydramnios
Fetal descent
Differential for LFDs
Big baby
Big mother
Wrong dates
Polyhydramnios
Fibroids
Multiple gestation
Breech
What parameters are important on fetal US to determine growth problems?
BPD (Biparietal diameter)
FOC (frontal occipital diameter)
Head circumference
Abdo circumference
femur length
Plot all of these on a growth centiles chart and estimate fetal weight
<10th centile - SFDs
>90th centile - LFDs
What monitoring is important in SFDs?
CTG
US - Fetal heart, fetal movement, presentation/lie, placenta location, AFI, DVP
Doppler
