RANZCOG Summaries

Question 1

EOIUGR
–> Explanation
–> Management

Answer 1

ISUOG Guidelines
Explanation :
- EOIUGR = before 32-34 weeks
- IUGR = EFW or AC <10%, with <3% at highest risk
- EOIUGR causes : placental insufficiency / maternal medical conditions, chromosomal/genetic, infective, constitutional
- Risk to mother : PET, CS
- Risk to baby : Preterm birth, stillbirth, perinatal mortality, longterm sequelae such as HTN, metabolic syndrome, T2DM, coronary heart disease, stroke
Management :
- Indications for admission?
- Tertiary obstetrics +/- MFM referral
- Confirm EDD from ?dating scan
- PET screen + BP checks (+/- sFlt-1/PlGF ratio)
- TORCH screens
- Amniocentesis - exclude infection, aneuploidy
- Trigger for steroids?
- If normal AFID - weekly AFI/dopplers
- If AEDF - consider second daily dopplers
- Triggers for delivery :
–> <32w
–> 32-34w
–> 34-37w
–> 37+
- MOD