small for dates Flashcards
define pre-term birth
delivery between 24 and 36+6 weeks
causes of preterm birth
infection multiple pregnancy polyhydramnios placental abruption intercurrent illness (UTI, appendicitis, pneumonia) cervical incompetence idiopathic
risk factors for pre-term birth
previous multiple pregnancy uterine anomalies teenagers parity = 0 or >5 smoking and drugs low BMI
what is intrauterine growth restriction
failure of growth in utero
risk factors for IUGR
smoking alcohol drugs maternal diseases (eg hypertension) infection (rubella, CMV, toxoplasma) congenital anomalies
signs of IUGR
fundal height less than expected
reduced foetal movements
reduced liquor
what determines a aby as small for gestational age
<10th centile for gestation on chart
describe difference between symmetrical and non-symmetrical IUGR
symmetrical - both head and abdomen small
non-symmetrical - only head or abdomen small, other is normal
antenatal risk of restricted growth
hypoxia
death
post-natal consequences of restricted growth
hypoglycaemia hypothermia polycythaemia hyperbilirubinaemia abnormal neurodevelopment
investigations to assess small growth
cardiotocograph
USS
dopller - measure end diastolic flow
what do accelerations in foetal heart rate at the start of a uterine contraction indicate
good reflex reactivity
what causes loss of baseline variability on CTG
sedative/analgesic drugs in labour
