SGA/IUGR Flashcards
IUGR
Slowing of foetal growth - growth velocity falls off on growth chart
SGA
Weight below 10th centile - marker for IUGR
Aetiology - maternal
Chronic disease - HTN, cardiac, renal failure Substance misuse - recreational, alcohol Autoimmune Poor nutrition Smoking Low socioeconomic status Uterine abnormality
Aetiology - placental
Abnormal trophoblastic invasion - accreta, pre-eclampsia Placental abruption Placenta praevia Tumours - chorangiomas Abnormal cord
Aetiology - foetal
Genetic - trisomys, turners
Congenital abnormality - ToF
Infection - CMV, rubella, toxoplasmosis
Multiple pregnancy
Most common cause
Uteroplacental insufficiency
Systemic growth restriction?
Entire body is small - often chromosomal
Poor prognosis
Asymmetric growth restriction
Undernourished foetus - compensates by directing to vital organs (head sparing)
Prognosis = relatively good
Low birth weight
<2.5kg
High risk patients
Previous IUGR (25%) Multiple pregnancy Pre-eclampsia (40% have IUGR) Maternal chronic conditions Drugs + smoking
Perinatal outcomes
Babys prone to complications - asphyxia, meconium aspiration, FD, hypoclycaemia, hypocalcaemia, emergency CS
10 x increase in morbidity and mortality
Long term complications
4 x cerebral palsy risk
30% stillbirths have IUGR
Learning difficulties
behavioural problems
Management of SGA with normal umbilical artery doppler
No intervention needed
Investigations
USS to confirm small baby and oligohydramnios
Growth charts
Tests for infections
Umbilical artery doppler
management of IUGR + abnormal doppler > 36 weeks
deliver (induction or CS)
