Small for dates

Question 1

Define preterm delivery

Answer 1

24-36 weeks

Question 2

Aetiology of pre-term delivery

Answer 2

Spontaneous 
Multiple pregnancy 
Infection
Vascular- placental abruption
Cervical incompetence
Polyhydramnios (excess amniotic fluid)

Question 3

Risk factors for pre-term delivery

Answer 3

previous pre-term delivery 
Conceived via IVF
Age- teenagers are at increased risk
Low BMI
Uterine abnormalities
Cocaine use, smoking, alcohol consumption

Question 4

What weight is classed as small for gestational age

Answer 4

<10th centile

i.e. <2.5kg

Question 5

what is Intra-uterine growth restriction (IUGR)

Answer 5

poor growth causing baby to be smaller than expected

Question 6

Maternal causes of IUGR

Answer 6

smoker, alcohol consumption, drug use, age, hypertension, weight

Question 7

fetal causes of IUGR

Answer 7

Infection (CMV, rubella)
Congenital abnormality (absent kidneys, chromosomal abnormality)

Question 8

placental causes of IUGR

Answer 8

Infarcts
Abruption
(often secondary to hypertension)

Question 9

What is symmetrical IUGR

Answer 9

small head, small abdomen

Question 10

What is asymmetrical IUGR

Answer 10

normal head, small abdomen

Question 11

Consequences of IUGR in labour

Answer 11

risk of hypoxia

Question 12

Consequences of IUGR post natally

Answer 12

Hypoglycaemia 
Hypothermia
Polycythaemia 
Hyperbilirubinaemia 
Abnormal neurodevelopment 
Asphyxia

Question 13

what is used to assess fetal heart beat

Answer 13

Cardiotocography

Question 14

what indicates good reflex reactivity of fetal circulation on cardiotocography

Answer 14

accelerations

Question 15

what is an acceleration

Answer 15

An increase in fetal HR at the start of the uterine contraction, returning to baseline before the start of the next

Question 16

is loss of baseline variability worrying?

Answer 16

YES

less variability = higher risk of asphyxia (O2 deprivation)