Small for Dates Flashcards
Term for small for dates?
Small for gestational Age
SGA
What is SGA?
Infant born with birth weight below the 10th centile
How is SGA picked up?
Because abdominal circumference or estimated fetal weight on US is below 10th centile
Low birth weight?
Infant with birth weight <2500g at any gestation
LBW goes hand in hand with SGA? True or false?
False
premature baby may have low birth weight but be an appropriate wt for its gestation
FGR?
Fetal growth restriction
What is FGR?
Failure to achieve genetic potential for growth, this implies pathological restriction of genetic growth potential
What should interventions be targeted to in SGA?
Below 3rd centile as these are more likely to have underlying pathology
Categories of causes of SGA?
Constitutionally small
Placental
Fetal
Maternal
Placental causes of SGA?
Infarcts
Abruption
Fetal causes of SGA?
Infection (CMV, rubella, congenital anomalies, chromosomal abnormalities)
Maternal causes of SGA?
Lifestyle, age, maternal disease
Constitutionally small cause of SGA means?
Mum and da are small
Small baba
Importance of identifying SGA?
Greater perinatal morbidity and mortality: antenatal and intrapartum hypoxia, hypoglycaemia, hypothermia, polycythaemia, hyperbilirubinemia
May need preterm delivery
SGA may be initial presentation of maternal disease (PEclam)
Major RF for SGA?
Abnormal uterine artery doppler at 20 weeks
What happens to women who have SFH measurements below 10th centile?
Referred for serial growth scan
How is SGA diagnosed?
US measurement of AC (abdo circumf) BPD (biparietal diameter) Femoral length (EFW)
If woman has factors meaning SFH might not be accurate?
Referred for US to monitor foetal weight
Factor indicating SFH measurements inaccuracy?
Fibroids
BMI > 35
Minimum management of SGA?
Serial growth scans with umbilical doppler and liquor volume (amniotic fluid)
Medical managemnet of SGA?
150mg aspirin at night from 12 weeks with women who have RF for Pre-ec or
If baby is below 3rd centile what should you offer in terms of delivery?
Delivery from 37 weeks (aim for before 38th week)
If baby is between 3-10th centile offer delivery when?
39 weeks
Abnoraml umbilical doppler can mean what and should what the be offered?
Can mean: increased chance of foetal distress in labour
Offer: c section
What can be offered below 32 weeks to protect against cerebral palsy?
Mg Sulfate
Why do earlier deliveries in SGA?
Stats show weeks 37-39 is safer as still term anyway and there is risk of placental insufficiency etc so better to get them out earlier
