prematurity Flashcards
low birth weight weight
<2499g
very low birth weight weight
<1500g
extremely low birth weight weight
<1000g
2/3 infant deaths weight
<2.5kg
IUGR refers to
bottom 10% of weight for gestational age plus chronic hypoxia or failure to thrive
hypoxia in IUGR which arteries
middle cerebral, umbilical
normal foetal growth by week
5g per day at 14-15 weeks of gestation
10g per day at 20 weeks
30-35g per day at 32-34 weeks
what is the measurement of the bump from top to bottom called
symphysiofundal height
what causes type 1 IUGR
genetic or infection
describe IUGR type 1 growth vs normal constitutional tiny person charts
what is type 2 IUGR - when, what associated with
asymmetric - after 28 weeks
Maternal hypertension and pre-eclampsia
Renal disease
Vasculopathies
Head sparing
normal cell number but small inside
hardly any fat, skin folds
what is type 1 IUGR
symmetrical
fewer cells in baby (less hyperplasia)
20-30%
post-partum IUGR complications (5)
Increased incidence of hypoxic ischemic encephalopathy
Persistent fetal circulation insufficiency (patent ductus arteriosus)
Difficulty in temperature regulation
Absent brown fat and small body mass to surface area
Poor glycogen stores may predispose to hypoglycemia
Chronic intrauterine hypoxia lead to polycythemia, necrotizing enterocolitis, other metabolic abnormalities
IUGR and meconium
higher incidence of aspiration
IUGR complications in babyhood
what lag in symphyshiofundal height is suggestive of IUGR
4 weeks
or 6 weeks severe
uterine fundus at 20wks
umbilicus
highest aetiology of IUGR
placental and cord abnormalities
what gives the greatest predictive value for IUGR
abdominal circumference of foetus
how can you tell symmetric vs asymmetric IUGR by measuring
centiles over time ratio. symmetric ratio is 1, asymmetric is head sparing so head stays on higher centile
what should umbilical artery doppler show in healthy baby, what does it show in IUGR
plenty of flow throughout diastole
absent or even reversed flow in diastole in IUGR
…reduces pre-term birth by 60%
vitamin D supplementaion
surfactant produced by
type 2 pneumocyte
how do you lower risk of intraventricular haemorrhage in preterm baby
maternal steroids
what drives angiogenesis
hypoxia
tummy prob in preterm neonate - who has it more commonly
necrotising enterocolitis
formula fed preterm
