Small Babies Flashcards
Small for gestational age (SGA) definition
abdominal circumference or estimated fetal weight less that the 10th centile
severe SGA = AC or EFW <3rd centile
Fetal growth restriction (FGR) definition
failure of the fetus to attain their growth potential
All babies below 3rd centile
Below 10th centile with evidence of placental dysfunction
low birth weight (LBW) definition
any baby born with a weight less than 2.5kg at any gestation
antenatal/in labour Risks of fetal growth restriction (FGR) and small for gestation age (SGA)
hypoxia
still birth
postnatal risks of fetal growth restriction (FGR) and small for gestational age (SGA)
- hypoglycaemia
- asphyxia
- hypothermia
- polycythaemia (abnormally high red cells in the blood)
- hyperbilirubinaemia
- abnormal neurodevelopment
- complications related to prematurity if preterm delivery
maternal causes of SGA
lifestyle: smoking, alcohol and drugs
very low or high BMI
Age
Maternal disease e.g. hypertension, renal disease
Placental causes of SGA
Infarctions
Abruption (Antepartum haemorrhage)
Association with hypertensive diseases
Foetal causes of SGA
Infection e.g. rubella, CMV, toxoplasmosis
Congenital anomalies
Chromosomal abnormalities
Prevention of SGA
Aspirin for those at risk of pre-eclampsia
Vit D supplementation for all
Smoking cessation
Drugs problems service input for those who require support
LMWH in those with antiphospholipid syndrome
what measurement can be used to detect SGA/FGR?
Symphysial fundal height (SFH) measurement
if high risk of FGR, how often are growth scans done?
every 4 weeks from 28 weeks (sometimes 24 weeks)
what puts someone at high risk of foetal growth restriction (FGR)?
- previous severe SGA
- previous stillbirth
- chronic hypertension on treatment
- diabetes
- renal disease e.g. nephropathy
- antiphospholipid syndrome
- lupus
- abnormal uterine artery doppler
What is magnesium sulphate used for in preterm birth?
fetal neuroprotection up to 29+6 weeks, consider 30-33+6 weeks
