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Foetus MSc - Riona > Normal and disordered foetal growth > Flashcards

Normal and disordered foetal growth Flashcards

1
Q

Define SGA

A

≤10th weight percentile for age

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2
Q

Define IUGR

A

Foetus unable to achieve genetically predetermined size (growth charts)

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3
Q

Define LBW

A

<2500g

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4
Q

What are the 3 types of SGA?

A

Normal
Abnormal
Growth restricted

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5
Q

What are the classifications for growth restriction?

A

Symmetrical

Asymmetrical

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6
Q

What is the normal brain:liver ratio and what is the asymmetrical growth restricted ratio?

A

3:1

>6:1

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7
Q

What is IUGR caused by?

A

Insufficient gas exchange and nutrient delivery to foetus

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8
Q

Give an example of a cause of IUGR for each maternal/foetal/placental

A

Maternal - chronic disease, infection, pre-eclampsia, malnutrition, drugs, infection, uterine abnormalities
Foetal - multiple pregnancy, infection, congenital, extra-uterine, chromosomal
Placental - defective trophoblastic invasion, lateral cord insertion, decreased blood flow, vascular abnormalities, small placenta, placental abruption/praevia

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9
Q

What are the names for trisomies 13/18/21?

A

13 - Patau’s
18 - Edward’s
21 - Down’s

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10
Q

Name 2 maternal mechanisms causing IUGR

A

Decreased O2 carrying capacity

Dysfunctional O2 delivery system

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11
Q

Define epigenetic alterations

A

Alterations of gene expression through covalent modifications of DNA and core histones (acetylation and methylation)

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12
Q

What are the 3 functions of the placenta?

A

Transport
Endocrine
Metabolism

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13
Q

Give 3 implications of IUGR

A

Increased morbidity and mortality
Prematurity and associated risks
Metabolic disease
Asphyxia

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14
Q

What is the thrifty hypothesis?

A

Metabolically deprived foetus becomes metabolically programmed for insulin resistance and impaired glucose metabolism

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15
Q

How do you diagnose IUGR?

A 
USS for placental, foetus, AFI
Fundal height and maternal weight
Risk factors
Uteroplacental and foetal Doppler
Amniocentesis 
Neonatal diagnosis
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16
Q

How do you manage IUGR?

A

Low dose aspirin and mini heparin
Reduce risk factors
Foetal surveillance until risk of death in utero > risk of delivery and prematurity

17
Q

Define LGA

A

≥90th weight percentile for age

18
Q

Define macrosomia

A

BW >4000g

19
Q

Give 3 risk factors for LGA and macrosomia

A 
Maternal obesity pre-pregnancy or increase during
Maternal hyperglycaemia
Male foetus
Age <20
Previous macrosomic child
Post-term
Parental height and race
20
Q

Hoq do you diagnose LGA?

A

Increased SFH

21
Q

Give 2 implications of LGA

A

Traumatic birth
Maternal DM
Foetal death
Neonatal hypoglycaemia

Foetus MSc - Riona (10 decks)

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