Large for Dates

Question 1

when is a baby considered large for date?

Answer 1

SFH >2cm for gestation

i.e. 32 weeks and SFH 36cm

Question 2

what is foetal macrosomia?

Answer 2

medical term for a big baby

Question 3

how is foetal macrosomia diagnosed?

Answer 3

ultrasound

look at EFW and AC

Question 4

what EFW suggests foetal macrosomia?

Answer 4

> 90th centile

estimated foetal weight

Question 5

what AC suggests foetal macrosomia?

Answer 5

> 97th centile

abdominal circumference

Question 6

what is labour dystocia?

Answer 6

failure to progress in labour

Question 7

what is shoulder dystocia?

Answer 7

when the babies anterior shoulder is trapped behind the mums pubic symphysis during the second stage of labour

Question 8

who is shoulder dystocia more common in?

Answer 8

diabetic patients

Question 9

when is c section needed for foetal macrosomia?

Answer 9

if EFW > 5kg

Question 10

what is IOL?

Answer 10

induction of labour

Question 11

what is polyhydramnios?

Answer 11

excess amniotic fluid

Question 12

when is polyhydramnios diagnosed?

Answer 12

amniotic fluid index (AFI) > 25cm

OR

single deepest pool measurement >8cm

Question 13

what are some possible causes of polyhydramnios?

Answer 13

idiopathic
maternal diabetes
foetal causes

Question 14

name four foetal causes of polyhydramnios

Answer 14

anomalies
monochorionic twin pregnancy
hydrops fetalis
viral infections

Question 15

what is the management of polyhydramnios?

Answer 15

serial USS to look at growth

IOL by 40 weeks

Question 16

what are the possible risks in labour caused by polyhydramnios?

Answer 16

malpresentation
cord prolapse
preterm labour
PPH

Question 17

what is multiple pregnancy?

Answer 17

the presence of more than one foetus

Question 18

what are the risk factors for multiple pregnancy?

Answer 18

assisted conception
family history
increased maternal age
increased parity

Question 19

what are the two types of multiple pregnancy?

Answer 19

monozygotic

dizygotic

Question 20

what causes a monozygotic multiple pregnancy?

Answer 20

splitting of a single fertilised egg

Question 21

what causes a dizygotic multiple pregnancy?

Answer 21

fertilisation of two ova by two sperm

more common

Question 22

what is chorionicty?

Answer 22

the number of placentas

Question 23

what does monochorionic mean?

Answer 23

one placenta

Question 24

what does dichorionic mean?

Answer 24

two placentas

Question 25

what is the chorionicity of a dizygotic pregnancy?

Answer 25

always DCDA

Question 26

what is the chorionicity of a monozygotic pregnancy?

Answer 26

can be MCMA, MCDA, DCDA or conjoined

depends on when the zygote splits

Question 27

what is the chorionicity of a monozygotic pregnancy splitting at days 0-3?

Answer 27

DCDA

Question 28

what is the chorionicity of a monozygotic pregnancy splitting at days 4-7?

Answer 28

MCDA

Question 29

what is the chorionicity of a monozygotic pregnancy splitting at days 8-14?

Answer 29

MCMA

Question 30

what is the chorionicity of a monozygotic pregnancy splitting at days 15 onwards?

Answer 30

conjoined twins

Question 31

what type of multiple pregnancy carries higher risk of pregnancy complications?

Answer 31

monozygotic

Question 32

when should ultrasounds be done for a monochorionic multiple pregnancy?

Answer 32

every two weeks from 16 week

Question 33

when should ultrasounds be done for a monochorionic multiple pregnancy?

Answer 33

every four weeks

Question 34

when should a DCDA multiple pregnancy be delivered?

Answer 34

37-38 weeks

Question 35

when should a MCDA multiple pregnancy be delivered?

Answer 35

after 36 weeks with steroids