Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Reproduction and Sexual Health > Small for Dates > Flashcards

Small for Dates Flashcards

1
Q

What are the 2 main groups of small babies?

A
  • Pre-term delivery.

* Small for gestational age.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 2 subcategories for SGA babies?

A
  • Intra-uterine growth retardation (IUGR). (placenta isn’t working properly and baby isn’t growing well)
  • Constitutionally small.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is pre-term birth defined as?

A

Delivery between 24 and 36+6 weeks.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the prevalence of pre-term babies?

A

Approx 6-7%.

Globally – 15million babies per year.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the survival rates like at i)24 weeks ii) 27 weeks iii) 32 weeks?

A

i) ~20-30%.
ii) 80%.
iii) >95%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

List some causes of pre-term birth.

A
  • Infection
  • ‘Over distension’
  • Vascular
  • Intercurrent illness
  • Cervical insufficiency (get painless dilatation of cervix, rupture of membranes and loss of the pregnancy)
  • Idiopathic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

List some intercurrent illnesses which may lead to pre-term birth.

A
  • Pyelonephritis / UTI
  • Appendicitis
  • Pneumonia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

List risk factors associated with pre-term birth.

A
  • Previous PTL (20% risk X1; 40% X2))
  • Multiple (50% risk)
  • Uterine anomalies
  • Age (teenagers)
  • Parity (=0 or >5)
  • Ethnicity
  • Poor socio-economic status
  • Smoking
  • Drugs (especially cocaine)
  • Low BMI (<20)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the biggest cause of pre-term birth (40%)?

A

Unknown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

25% of pre-term births are planned caesarean sections. Why might one of these be required?

A
  • Severe pre-eclampsia.
  • Kidney disease.
  • Poor foetal development.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the other 25% of pre-term births caused by?

A

Emergency events – placental abruption, infection, eclampsia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What causes 20% of pre-term births?

A

Premature rupture of membranes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What do steroids help with in the context of pre-term birth?

A

Maturation of type 2 pneumocytes in the lungs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What improves time form ruptured membranes to delivery?

A

Erythromycin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe placenta abruption.

A

Hard, ‘woody’ abdomen and uterus, with contractions occurring one after the other

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is small for gestational age defined as?

A

An infant with birthweight that is less than the 10th centile for gestation corrected for maternal weight, fetal sex and birth order.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

If the 10th centile is used as the cut off for SGA, 50% . .

A

Will be fine, just small, while the other half will probably be running into problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What 3 factors can poor growth be attributed to?

A

1 – Maternal.
2 – Foetal.
3 – Placental.

19
Q

List maternal factors which may contribute to poor growth.

A
  • Lifestyle - smoking, alcohol, drugs (esp cocaine)
  • Height and weight (low/high BMI)
  • Age.
  • Maternal disease e.g. hypertension, diabetes (assoc. w/ macrosomia, but can sometimes cause vascular problems in the placenta and result in IUGR).
20
Q

What foetal factors may contribute to poor growth?

A
  • Infection e.g. rubella, CMV, toxoplasma.
  • Congenital anomalies e.g. absent kidneys.
  • Chromosomal abnormalities e.g. Down’s syndrome.
21
Q

What placental factors may contribute to poor growth?

A
  • Infarcts.
  • Abruption.
  • Often secondary to hypertension.
22
Q

If a baby is <10th centile, it can be categories as either ….

A
  1. SGA

2. IUGR

23
Q

Late onset IUGR – tends to be associated with a normal head, and small abdomen.

A

TRUE

24
Q

IUGR can be either ….

A

Symmetrical
OR
Asymmetrical

25
Q

Antenatally, or in labour, what is there a risk of?

A

Hypoxia +/or death

26
Q

What are the potential post-natal consequences of being growth restricted?

A
  • Hypoglycaemia
  • Effects of asphyxia
  • Hypothermia
  • Polycythaemia
  • Hyperbilirubinaemia
  • Abnormal neurodevelopment
27
Q

What are the clinical features of poor growth?

A
  • Predisposing factors.
  • Fundal height less than expected.
  • Reduced liquor.
  • Reduced fetal movements.
28
Q

What should fundal-symphyseal height be roughly equal to?

A

Number of weeks gestation +/-2cm.

29
Q

What are the components of an assessment of foetal wellbeing?

A
  • Assessment of growth.
  • Cardiotocography.
  • Biophysical assessment.
  • Doppler ultrasound.
30
Q

On US, what should be measured when assessing growth?

A

Head circumference.
Abdominal circumference.
Femur length.

31
Q

Outline the 2 parts of CTG.

A

1 – picks up the fetal heart rate with doppler US.

2 – picks up contractions.

32
Q

What is the normal foetal heart rate?

A

110-160 bpm

33
Q

What can loss of baseline variability on a CTG indicate?

A

Greater possibility of asphyxia

34
Q

Longer lag time of decelerations on CTG ….

A

More serious foetal asphyxia

35
Q

What does assessment of foetal wellbeing involve and consider?

A
  • Ultrasound assessment.
  • Considers:
  • movement.
  • tone.
  • foetal breathing movements.
  • liquor volume.
36
Q

How is assessment of foetal wellbeing scored?

A

Out of 10:

  • 8-10 = satisfactory.
  • 4-6 = repeat.
  • 0-2 = deliver.
37
Q

What does the umbilical arterial doppler use?

A

US

38
Q

What does the umbilical arterial doppler measure during foetal assessment?

A

Placenta resistance to flow

39
Q

What vessels run through the umbilical cord?

A

2 little arteries and 1 big vein (looks like a smiley face).

40
Q

What does a doppler trace look like?

A

Toblerone, with lots of ‘chocolate’ between the chunks.

41
Q

What happens to blood flow if placenta isn’t working or the baby is anaemic? Why?

A

You get faster blood flow in the brain

The blood is being diverted to the more essential organs

42
Q

Describe the ductus venosus doppler.

A

From the umbilical vein into the heart.

Little wave you see is a reflection of cardiac contractility.

43
Q

What is the danger of delivery which is too early?

A

Iatrogenic prematurity

44
Q

What is the danger of delivering a baby too late?

A

Perinatal asphyxia/IUFD (intra-uterine foetal demise).

Reproduction and Sexual Health (51 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions