Large for Dates Flashcards
why might a female be large for dates
wrong dates- more pregnant than she thought!
Fetal macrosomia
Polyhydramnios
Multiple pregnancy
what is fetal macrosomia
‘big baby’
>90th centile
presentation of polyhydramnios
tense shiny abdomen
caused of polyhydramnios
maternal diabetes
fetal anomaly
monochorionic twin pregnancy
Hydrops fetalis
what is hydrops fetalis
abnormal accumulation of fluid in 2 or more fetal compartments
Investigation for polyhydramnios
USS
Serology (toxoplasmosis, CMV, parvovirus)
what does monozygotic twins mean
splitting of a single fertilised egg
identical twins
what does dizygotic twins mean
fertilisation of 2 ova by 2 sperm
non identical twins
which type of twin pregnancy is at higher risk of complications?
monozygotic
What is chorionicity
membrane pattern
what does monochorionic mean
one membrane
how is twin chorionicity determined
USS- shape + thickness of the membrane
What does a Lambda sign on USS mean
Dichorionic diamniotic
(Two membranes, two amniotic sacs
what does T sign on USS mean
Monochorionic diamniotic
One membrane, two amniotic sacs
signs/symptoms of multiple pregnancy
Excessive sickness
High AFP
Large for dates
Multiple fetal poles
maternal complications of multiple pregnancy
Hyperemesis gravidarum (excessive N+V) Aenaemia Pre-eclampsia Antepartum haemorrhage C-section
fetal complications of multiple pregnancy
Congenital abnormality pre-term labour growth restriction cerebral palsy twin-twin transfusion syndrome
what is given to women with a multiple pregnancy to prevent complications
Give Iron, folic acid, low dose aspirin
what is gestational diabetes
carbohydrate intolerance resulting in hyperglycaemia of variable severity with onset during pregnancy
complications of gestational diabetes
overgrowth of insulin sensitive tissues in the fetus- macrosomia
hyperaemic state in uterus
Neonatal hypoglycaemia
when is gestational diabetes screened for
28 weeks
Diagnostic values for gestational diabetes
fasting > 5.1 mmol/l
2 hours > 8.5 mmol/l
1st line management for gestational diabetes
diet, lose weight, exercise
2nd line management for gestational diabetes
metformin
insulin
