Small and large for dates

Question 1

what’s the definition of pre-term birth

Answer 1

–Delivery between 24 and 36+6 weeks

Question 2

what is the aetiology of pre-term births

Answer 2

• Infection
• ‘Over distension’:

–Multiple

–Polyhydramnios

•Vascular:

–Placental abruption

•Intercurrent illness:

–Pyelonephritis / UTI

–Appendicitis

–Pneumonia

• Cervical incompetence
• Idiopathic

Question 3

what is the definition of small for gestational age

Answer 3

less than 10th centile

Question 4

list aetiologies for a lorge for dates pregnancy

Answer 4

Wrong dates

Multiple pregnancy

Diabetes

Polyhydramnios

Question 5

what is the definition of polyhydramnios?

Answer 5

Excess amniotic fluid

Question 6

what are the causes of polyhydramnios

Answer 6

Monochorionic twin pregnancy

Fetal anomaly

Maternal diabetes

Hydrops fetalis – Rh isoimmunisation, infection (erythrovirus B19)

Ideopathic

Question 7

what are the complications of polyhydramnios?

how is it diagnosed?

Answer 7

–Discomfort

–Labour

–Membrane rupture

–Cord prolapse

Ultrasound

Question 8

when are twins usually diagnosed?

Answer 8

12 week ultrasound

Question 9

what are multiple pregnancy complications?

Answer 9

–Congenital anomalies

–Pre term labour

–Growth restriction

–Pre eclampsia

–Antepartum haemorrhage

–Twin to twin transfusion

Question 10

Managemtn for multiple pregnancy?

Answer 10

• More frequent antenatal visits
• Detailed anomaly scan at 18 weeks
• Regular scans from 28 weeks for growth
• Routine iron supplementation
• Warning to mother re risk and signs of pre term labour

Question 11

what is the aetiology behind gestational diabetes?

Answer 11

placental hormones cause insulin resistance

Question 12

when and how are woman screened for diabetes?

Answer 12

Women screened for GTT based on risk factors or random blood glucose at booking and 28 weeks gestation

Diagnosis based on GTT at 28 weeks

Diagnostic values:

Fasting >=5.1 mmol/l

2 hour >=8.5 mmol/l

Question 13

what are the complications of Gest Diabetes?

Answer 13

–Congenital anomalies

–Miscarriage

–Intra uterine death

–Pre eclampsia

–Polyhydramnios

–Macrosomia

–Shoulder dystocia

–Neonatal hypoglycaemia

Question 14

What are blood glucose level targets in gestational diabetes?

Answer 14

Fasting

3.5 -5.9 mmol/l

1 hour post prandial

<7.8 mmol/l

Question 15

what is the risk of developing diabetes after pregnancy if lady has gest. diab?

Answer 15

70%