Large/Small for Gestational Age Flashcards
define large for gestational age
> 90th percentile of estimated foetal weight
LGA also known as
macrosomia
birth weight of a baby considered large for gestational age
> 4.5kg at birth
other than constitutional, give some reasons that a foetus may be large for gestational age
maternal diabetes
maternal obesity
maternal rapid weight gain
previous macrosomal baby
overdue
6 risks to the mother as a result of macrosomia
shoulder dystosia
failure to progress
perineal tears
uterine rupture (rare)
necessity of instrumental delivery
PPH
4 complications to the child as a result of macrosomia (2 immediate and 2 long term)
increased risk of birth complication e.g. Erb’s palsy
neonatal hypoglycaemia (due to raised insulin?)
obesity
T2DM
other than macrosomia, what else will cause a larger than normal uterus?
polyhydramnios
multiple pregnancy
mothers with macrosomal babies should be investigated for
polyhydramnios
multiple pregnancy
true or false: the vast majority of LGA babies will have complicated births
what is the implication of this?
false; most LGA babies will have a normal vaginal delivery
NICE does not recommend induction of labour on the grounds of macrosomia alone
main risk of vaginal delivery with a LGA baby
shoulder dystocia
define SGA
below the 10th centile for their gestational age
how is foetal size estimated? (2)
USS can be used to determine:
estimated foetal weight
abdominal circumference
suggest 4 factors which need to be taken into account when considering if a foetus is SGA (4 maternal factors)
ethnicity
weight
height
parity
define severe SGA
below the third centile
define low birth weight
<2500 g