Low birth weight/IUGR/SGA

Question 1

Definition of low birth weight?

Answer 1

Weighing less than 2.5kg when born

Question 2

Physiological factors affecting growth and weight

Answer 2

Maternal height and weight
Parity –> Increased parity = increased weight
Ethnic origin
Gender

Question 3

Definition of large birth weight?

Answer 3

Weighing more than 8 pounds, 13 ounces (4kg) regardless of gestational age

Question 4

Definition of small for dates?

Answer 4

Weight below the 10th centile for corresponding gestational age

Question 5

Definition of large for dates (fetal macrosomia)?

Answer 5

Above the 95th centile for corresponding gestational age

Question 6

Definition of Intrauterine growth restriction

Answer 6

Restriction of fetal growth in-utero

Question 7

Risk factors for IUGR? Give me 6.

Answer 7

Maternal - Smoking, nulliparity
Placental - pre-eclampsia, placental insufficiency, placenta accreta
Fetal - Infection i.e CMV, Trisomies, cardiac abnormalities

Question 8

Types of IUGR and what are their causes?

Answer 8

Symmetrical IUGR - genetic, infection

Asymmetrical (head sparing) - placental factors, smoking, Essential HTN

Question 9

Monitoring for macrosomia

Answer 9

Serial growth scans - Biophysical profile

Non-stress test (HR and uterine contractions)

Question 10

Marker for SGA

Answer 10

PAPP-A (1st trimester)

Question 11

Investigations for SGA

Answer 11

Umbilical artery doppler
Test for malaria/syphilis (high risk groups)
Screen for TORCH if severe
Karyotyping if severe
Non-stress test
Serial growth scans

Question 12

When to screen for SGA and how?

Answer 12

If woman 3 or more minor risk factors, perform uterine artery doppler at 20 -24 weeks

Question 13

Investigations for IUGR

Answer 13

Umbilical artery doppler

Question 14

Treatment for SGA

Answer 14

IOL by 37 weeks (if dopplers normal)

LSCS (if reversed or absent doppler flow)

Question 15

Consequences of macrosomia?

Answer 15

Hypoglycaemia
Neonatal jaundice
Respiratory distress
Polycythaemia