Small and Large for Dates Flashcards

1
Q

what are the 3 main causes of a SGA baby

A

prematurity
constitutionally small
intra-uterine growth restriction

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2
Q

preterm delivery is classified as birth before how many weeks

A

37 weeks

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3
Q

outline some of the causes of prematurity

A

infection
over distension due to multiple pregnancy and polyhydramnios
vascular - placental abruption
cervical incompetence

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4
Q

a SGA foetus is below which centile on growth charts

A

below 10th centile

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5
Q

list some of the minor risk factors for IUGR

A
maternal age between 35 and 40
smokes 1-10 cigarettes a day
BMI <20 
low fruit pre-pregnancy 
previous pre-eclampsia 
pregnancy interval <6 months or >60 months
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6
Q

list some of the major risk factors for IUGR

A
maternal age >40
smokes >10 a day
previous SGA baby 
chronic hypertension 
renal impairment 
anti-phospholipid syndrome 
BMI >35
known large fibroids
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7
Q

what causes a symmetrical IUGR

A

something affecting the whole foetus - chromosomal abnormalities, TORCH infections

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8
Q

what causes an asymmetrical IUGR

A

a placental defect, all the nutrients goes to the foetus’ head to preserve brain development over other organs.
conditions such as pre-eclampsia, malnutrition and chronic hypoxia

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9
Q

how is a woman with a single major risk for IUGR managed

A

umbilical artery doppler from 26 weeks to assess foetal size

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10
Q

how is a woman with 3 minor risks for IUGR managed

A

umbilical artery doppler from 24 weeks to assess foetal size

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11
Q

when is delivery usually planned for a SGA foetus

A

37 weeks if no umbilical artery doppler abnormalities

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12
Q

what drugs are given to improve a SGA foetus’ maturing after birth

A

corticosteroids to improve lung maturity

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13
Q

define a LGA foetus

A

estimated foetal weight >90th centile

symphyseal fundal height will be more than 2cm for gestational age

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14
Q

list the causes of LGA foetus’

A

polyhydramnios
multiple pregnancy
macrosomia
wrong dates if late booker

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15
Q

list some of the main complications of LGA

A

maternal anxiety
shoulder dystocia
post partum haemorrhage

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16
Q

what is polyhydramnios

A

excessive amniotic fluid, amniotic fluid index >25cm and the deepest vertical pool >8cm

17
Q

what causes polyhydramnios

A

maternal diabetes
foetal anomaly - cannot swallow enough fluid
monochorionic twin pregnancy

18
Q

what are the signs and symptoms of polyhydramnios

A

abdo discomfort, PPROM, preterm labour, cord prolapse

malpresentation, shiny tense abdomen, inability to feel foetal parts

19
Q

what is the difference between monozygotic and dizygotic pregnancies

A

monozygotic - splitting of single fertilised egg

dizygotic - fertilisation of 2 ova by 2 sperm

20
Q

chronicity refers to what

A

how many placentas in a twin pregnancy

21
Q

how is chronicity assessed

A

ultrasound, assesses the shape and thickness of the membrane

22
Q

how are triplets delivered

A

c-section

23
Q

which type of twin pregnancy is always delivered by c-section

A

monochorionic mono amniotic due to risk of cord entanglement

24
Q

what is given after the delivery of twin 1 to aid the contractions for the delivery of twin 2

A

syntocinon

25
Q

what is twin-twin transfusion syndrome

A

disproportionate blood supply to foetuses in monochorionic pregnancies – as a placenta is shared the blood supply can flow from the donor twin to recipient twin causing complications for both

26
Q

outline the complications for the donor and recipient twin in TTTS

A

donor - reduced blood volume and urine output, poor growth, oligohydramnios
recipient - increased blood and urine output, polyhydramnios, polycythaemia, heart failure

27
Q

how is TTTS managed

A

fetoscopic laser ablation before 26 weeks

aim to deliver between 34-36 weeks