Neonatal and Foetal Growth Concerns Flashcards
What is the definition of a low birthweight (LBW) infant?
An infant with a birthweight of less than 2,500 grams (5.5 lbs).
What are the classifications of birthweight?
Low birthweight (LBW): < 2,500 g
Very low birthweight (VLBW): < 1,500 g
Extremely low birthweight (ELBW): < 1,000 g
An infant with a birthweight less than __________ grams is considered very low birthweight (VLBW).
1500
What are the common causes of low birthweight?
Prematurity (gestational age < 37 weeks)
Intrauterine growth restriction (IUGR)
Placental insufficiency
Multiple pregnancy
Maternal factors: smoking, alcohol, drugs, malnutrition, infections (e.g., TORCH)
What is placental insufficiency?
A condition where the placenta fails to deliver adequate oxygen and nutrients to the fetus, leading to growth restriction and low birthweight.
What are risk factors for placental insufficiency?
Maternal hypertension (chronic or gestational)
Preeclampsia
Diabetes
Smoking
Autoimmune disorders (e.g., lupus)
Placental abruption
Infections
What are common features of low birthweight infants?
Small size for gestational age
Thin, wrinkled skin
Prominent ribs
Weak cry and low muscle tone
Hypoglycemia
Placental insufficiency often leads to __________, a condition where the fetus does not reach its expected growth potential.
Intrauterine growth restriction (IUGR)
What investigations help diagnose low birthweight or placental insufficiency?
Ultrasound: to assess fetal growth, estimated fetal weight (EFW), and amniotic fluid
Umbilical artery Doppler: to evaluate blood flow to the fetus
Biophysical profile (BPP): fetal well-being assessment
Maternal investigations: blood pressure, glucose tolerance test (GTT), infection screening
True/False
Q: Low birthweight is always caused by prematurity.
False – It can also result from intrauterine growth restriction (IUGR) or placental insufficiency.
What are the potential complications of low birthweight?
Hypothermia
Hypoglycemia
Neonatal respiratory distress
Sepsis
Necrotizing enterocolitis (NEC)
Long-term developmental delays
What complications are associated with placental insufficiency?
Stillbirth
Preterm birth
Hypoxia
Fetal distress during labor
Oligohydramnios
Match the condition with its contribution to low birthweight:
Smoking
Hypertension
Placental abruption
A: Reduced oxygen delivery
B: Placental dysfunction
C: Premature delivery
1 → A
2 → B
3 → C
How is a low birthweight infant managed?
Temperature control: warm environment to prevent hypothermia
Nutritional support: early feeding or IV fluids
Monitor blood glucose: prevent hypoglycemia
Infection prevention: sterile environment and close monitoring
Respiratory support: if needed
What is the management for placental insufficiency during pregnancy?
Frequent monitoring (e.g., Doppler ultrasounds, fetal heart rate monitoring)
Aspirin therapy for high-risk patients
Control maternal conditions (e.g., hypertension)
Early delivery if fetal distress is detected
The primary investigation to monitor placental blood flow is __________ Doppler.
Umbilical artery
A pregnant woman with chronic hypertension has an ultrasound showing the fetus is below the 10th percentile for weight, with abnormal umbilical artery Doppler findings. What condition is most likely?
Placental insufficiency with IUGR
What strategies can help reduce the risk of low birthweight?
Smoking cessation
Good glycemic control in diabetes
Treating maternal infections
Early detection of hypertension and preeclampsia
Antenatal aspirin for high-risk pregnancies
What factors influence the prognosis of a low birthweight infant?
Gestational age at birth
Severity of growth restriction
Presence of complications (e.g., hypoxia, sepsis)
Nutritional and medical support provided
