Optimal method and frequency of fetal surveillance in a SGA infant and

Question 1

Umbilical artery Doppler and timing of delivery

Answer 1

• When umbilical artery Doppler are normal repeat surveillance every 14 days.
• When umbilical artery Doppler are abnormal (pulsatility or resistance index > +2 SDs) and delivery is not indicated repeat surveillance twice weekly in fetuses with end–diastolic flow present and daily in fetuses with absent/reversed end–diastolic flow
• When defined by customised fetal weight standards 81% of SGA fetuses have a normal umbilical
  artery Doppler - outpatient monitoring is appropriate

Question 2

Amniotic fluid measuraments and SGA

Answer 2

• Should not used a single form of surveillance
• ## Should be calculated as single deepest vertical pool

Question 3

Middle cerebral artery Doppler and SGA

Answer 3

• In the preterm SGA, MCA Doppler has limited accuracy to predict acidaemia and adverse outcome and should not be used to time delivery.
• In the term SGA, with normal umbilical artery Doppler, an abnormal MCA Doppler
  (PI

Question 4

Ductus venosus (DV) and umbilical vein (UV) Doppler in SGA

Answer 4

• Ductus venosus should be used for surveillance in the preterm SGA fetus with abnormal umbilical artery Doppler and used to time delivery.
• It reflects atrial pressure–volume changes during the
  cardiac cycle
• A retrograde a–wave and pulsatile flow in the umbilical vein (UV) signifies the onset of overt fetal cardiac compromise