Obstertrical Complications 2 Flashcards
3 main causes of intrauterine growth restriction?
Maternal, fetal, and placental
4 big maternal causes of IUGR?
Poor nutrition, cigarette smoking, alcohol, drugs
What do we mean when we say placental causes of IUGR? 3 conditions that falls under this category?
Things not able to transfer or get across the placenta.
HTN, renal disease, diabetes
What are the pathogens that can cross the placenta?
TORCH
How do we best define IUGR?
Birth weight below the 10% for a given gestational age
What is the pre pregnancy management of IUGR and antepartum management of IUGR?
Pre pregnancy is to get control of chronic conditions like diabetes of HTN
Antepartum is decrease any modifying factors like improving nutrition, stop smoking, etc.
3 tests we do to monitor IUGR during pregnancy?
Non stress test twice weekly
Biophysical profile
Doppler studies of umbilical artery
What are normal results for non stress test before and after 32 weeks?
Before 32: HR jumps above baseline for at least 10 seconds twice in a 20 minute period
After 32: HR jumps above baseline for at least 15 seconds twice in a 20 minute period
What is a biophysical profile?
Non stress test with a fetal US that evaluates baby breathing, body movements, muscle tone and amniotic fluid level.
If US shows IUGR and greater than 38 weeks, what do we do? What if less than 38 weeks, what do we do?
Deliver
Antenatal testing. If normal, continue pregnancy. If abnormal, deliver.
2 things IUGR babies need to be checked for right after birth?
Glucose and respiratory status
IUGR babies are at greater risk for what 3 things later in life?
Adult diabetes, HTN and atherosclerosis
Baby has lost subcutaneous fat, long fingernails, dry skin and peeling hair, what am I thinking?
Postmaturity syndrome
What is the preferred plan of care for postterm pregnancy?
Induction at 41 weeks
