Small for dates Flashcards
what are the reasons a baby can be small
pre term delivery
small for gestational age - just small or IUGR
definition of pre term birth
survival rates at 24, 27 and 32 weeks
between 24 and 36 weeks
24 - 50%
27-80%
32->95%
pre term birth causes
infection over distention vascular intercurrent illness cervical insufficiency PPROM idiopathic
give some causes of over distention
multiple preg
polyhydramnios
fibroids
give some causes of vascular
placental abruption - small bit of the placenta separates and bleeds
give some causes of intercurrent illness
polynephritis/UTI
appendicitis
pneumonia
what does cervical insuffieciency mean
starts to open and dilate at early point
what does PPROM mean
preterm premature rupture of the membrane
what are some of the risk factors associated with pre term birth
previous pre term labour multiple preg (50% risk) uterine anomalies age - teens parity =0 or >5 ethnicity poor socio economic status smoking drugs - esp cocaine low BMI <20
how many pre term births are planned C sections?
what are other causes
25% - severe eclampsia, kidney disease or poor fatal development
20% premature rupture of membranes -> vaginally
25% emergency event - placental abruption, infection, eclampsia
rest unknown
what are the two causes for a baby being small and what is the cut off
<10th centile
small for gestational age
intra uterine growth restriction
what are the three main causes for IUGR
maternal
fetal
placental
maternal factors for IUGR
smoking, alcohol, drugs
height and weight
age - extremities
hypertension, pre eclampsia
fetal factors for IUGR
infection - rubella, CMV, toxoplasma
congenital disease sth as absent kidneys
chromosomal abnormalities such as downs syndrome
placental factors for IUGR
infarcts
abruption
often secondary to hypertension of pe eclampsia
