Small for dates Flashcards
What are causes for small for dates baby
Pre term delivery
Small for gestational age
IUGR/FGR
Constitutionally small
When is a delivery described as pre term
before 37/40 weeks
i.e between 24-36+6 weeks
timings of moderate-late preterm
32-36+6 weeks
very pre term timings
28-31+6 weeks
extreme pre term timings
24-27+6 weeks
What are causes for pre term delivery
infection overdistension - multiple pregnancy or polyhydramnios idiopathic cervical incompetence vascular - placental abruption intercurrent illness in mother
List RF for pre term delivery
previous pre term delivery multiple pregnancy uterine abnormalities teenagers BMI<20 smokers poor socioeconomic class
Define small for gestational age (SGA) foetus
EFW or AC < 10th centile
Define intrauterine growth restriction IUGR / foetal growth restriction FGR
failure to achieve true growth potential
define low birth weight
baby <2.5kg regardless of gestation and delivery
describe symmetrical IUGR and its causes
small head + small abdomen
chromosomal abnormalities
infection
describe asymmetrical IUGR
NORMAL head + small abdomen
placental abnormality
what is used to diagnose SGA foetus
AC, head circumference, femur lengths
liquor volume, amniotic fluid index
list causes for SGA
Maternal: smoking, BMI, age, HTN or other maternal disease
Placental: infarcts, abruption, 2ndary to HTN
Foetal: infection, anomalies, chromosomal abnormalities
what is a uterine artery doppler test and when is it done
all women get this at 20 weeks scan
identifies resistance in uterine arteries –> SGA
normally there should be no resistance in uterine arteries
List consequences of IUGR
hypoxia death asphyxia hypothermia polycythaemia hyperbilirubinaemia still birth
methods of assessing IUGR
serial growth scans: 28, 32, 36/40
cardiotocography
biophysical assessment: USS - movement, tone, foetal breathing, liquor volume
doppler USS: placental and brain MCA and ductus venosus
What should delivery timings be in SGA if all is well
37 weeks
what are the indications for early c-section delivery
static growth
abnormal umbilical artery doppler
abnormal MCA doppler at 32-37 weeks
What should be given to babies born before 36 weeks
steroids to promote foetal lung maturity
When do you give magnesium sulphate and what is its benefit
born <32 weeks
provides neuroprotection against cerebral palsy
uterine arteries should have low/high resistance in a normal pregnancy
low resistance
difference between uterine and umbilical artery doppler
uterine - all women get this at 20 weeks
umbilical - used to assess foetal wellbeing in 3rd trimester, marker of placental insufficiency
SGA is the same as IUGR, true or false
false
umbilical arteries contain oxygenated/deoxygenated blood
deoxygenated
umbilical veins carry oxygenated/deoxygenated blood
oxygenated
