Large for Dates Flashcards
when is a baby considered large for date?
SFH >2cm for gestation
i.e. 32 weeks and SFH 36cm
what is foetal macrosomia?
medical term for a big baby
how is foetal macrosomia diagnosed?
ultrasound
look at EFW and AC
what EFW suggests foetal macrosomia?
> 90th centile
estimated foetal weight
what AC suggests foetal macrosomia?
> 97th centile
abdominal circumference
what is labour dystocia?
failure to progress in labour
what is shoulder dystocia?
when the babies anterior shoulder is trapped behind the mums pubic symphysis during the second stage of labour
who is shoulder dystocia more common in?
diabetic patients
when is c section needed for foetal macrosomia?
if EFW > 5kg
what is IOL?
induction of labour
what is polyhydramnios?
excess amniotic fluid
when is polyhydramnios diagnosed?
amniotic fluid index (AFI) > 25cm
OR
single deepest pool measurement >8cm
what are some possible causes of polyhydramnios?
idiopathic
maternal diabetes
foetal causes
name four foetal causes of polyhydramnios
anomalies
monochorionic twin pregnancy
hydrops fetalis
viral infections
what is the management of polyhydramnios?
serial USS to look at growth
IOL by 40 weeks
what are the possible risks in labour caused by polyhydramnios?
malpresentation
cord prolapse
preterm labour
PPH
what is multiple pregnancy?
the presence of more than one foetus
what are the risk factors for multiple pregnancy?
assisted conception
family history
increased maternal age
increased parity
what are the two types of multiple pregnancy?
monozygotic
dizygotic
what causes a monozygotic multiple pregnancy?
splitting of a single fertilised egg
what causes a dizygotic multiple pregnancy?
fertilisation of two ova by two sperm
more common
what is chorionicty?
the number of placentas
what does monochorionic mean?
one placenta
what does dichorionic mean?
two placentas
what is the chorionicity of a dizygotic pregnancy?
always DCDA
what is the chorionicity of a monozygotic pregnancy?
can be MCMA, MCDA, DCDA or conjoined
depends on when the zygote splits
what is the chorionicity of a monozygotic pregnancy splitting at days 0-3?
DCDA
what is the chorionicity of a monozygotic pregnancy splitting at days 4-7?
MCDA
what is the chorionicity of a monozygotic pregnancy splitting at days 8-14?
MCMA
what is the chorionicity of a monozygotic pregnancy splitting at days 15 onwards?
conjoined twins
what type of multiple pregnancy carries higher risk of pregnancy complications?
monozygotic
when should ultrasounds be done for a monochorionic multiple pregnancy?
every two weeks from 16 week
when should ultrasounds be done for a monochorionic multiple pregnancy?
every four weeks
when should a DCDA multiple pregnancy be delivered?
37-38 weeks
when should a MCDA multiple pregnancy be delivered?
after 36 weeks with steroids
