olighydram + SGA + teratogens Flashcards
olighydramnios
reduced amniotic fluid
- <500ml at 32-36wks
- amniotic fluid index <5th percentile
causes of oligohydramnios
- premature rupture of membranes
- potter sequence (bilateral renal agenesis + pulmonary hypoplasia)
- intrauterine growth restriction
- post term gestation
- preeclampsia
when should fetal movements establish
by 24wks gestation
- if no movements felt - refer to maternal fetal medicine unit
risk factors for reduced fetal movements
posture - more prominent when lying down, less when sitting/standing
distractable
anterior placenta position
medication - alcohol, sedatives
obesity
both oligohydramnio + polyhydramnios can cause reduction
small fetus
how should reduced fetal movements be investigated
handheld doppler to confirm heart beat
- if no, then immediate US
- then use CTG for at least 20mins
affect of ACEi, carbamazepine + lithium on fetus
ACEi - renal dysgenesis, craniofacial abnormalities
carbamazepine - neural tube defects, craniofacial abnormalities
Lithium - Ebsteins anomaly (atrialised right ventricle)
affect of chloramphenicol + aminoglycosides(gentamicin) + tetracylines (deoxy) on fetus
chloramphenicol - “grey baby” syndrome
gentamicin - ototoxicity
tetracyclines - discoloured teeth(blue?)
affect of alcohol, cocaine + smoking on fetus
alcohol - craniofacial abnormalities
cocaine - intrauterine growth retardation, hypertension/pre-eclampsia in preg, placental abruption
smoking - preterm labour, intrauterine grother retardation, miscarriage/stillbirth, sudden unexpected death in infancy
can you give warfarin during preg
no - craniofacial abnormalities
what are SGA babies at risk of
hypothermia
hypoglycaemia
polycythaemia
fetal alcohol syndrome
learning difficulties
faces - smooth philtrum, thin vermillion, small palpebral fissures, epicanthic, microcephaly
IUGR + postnatal restricted growth
