Small for dates

Question 1

What are causes for small for dates baby

Answer 1

Pre term delivery
Small for gestational age
IUGR/FGR
Constitutionally small

Question 2

When is a delivery described as pre term

Answer 2

before 37/40 weeks

i.e between 24-36+6 weeks

Question 3

timings of moderate-late preterm

Answer 3

32-36+6 weeks

Question 4

very pre term timings

Answer 4

28-31+6 weeks

Question 5

extreme pre term timings

Answer 5

24-27+6 weeks

Question 6

What are causes for pre term delivery

Answer 6

infection 
overdistension - multiple pregnancy or polyhydramnios
idiopathic 
cervical incompetence 
vascular - placental abruption 
intercurrent illness in mother

Question 7

List RF for pre term delivery

Answer 7

previous pre term delivery 
multiple pregnancy 
uterine abnormalities 
teenagers 
BMI<20 
smokers 
poor socioeconomic class

Question 8

Define small for gestational age (SGA) foetus

Answer 8

EFW or AC < 10th centile

Question 9

Define intrauterine growth restriction IUGR / foetal growth restriction FGR

Answer 9

failure to achieve true growth potential

Question 10

define low birth weight

Answer 10

baby <2.5kg regardless of gestation and delivery

Question 11

describe symmetrical IUGR and its causes

Answer 11

small head + small abdomen
chromosomal abnormalities
infection

Question 12

describe asymmetrical IUGR

Answer 12

NORMAL head + small abdomen

placental abnormality

Question 13

what is used to diagnose SGA foetus

Answer 13

AC, head circumference, femur lengths

liquor volume, amniotic fluid index

Question 14

list causes for SGA

Answer 14

Maternal: smoking, BMI, age, HTN or other maternal disease
Placental: infarcts, abruption, 2ndary to HTN
Foetal: infection, anomalies, chromosomal abnormalities

Question 15

what is a uterine artery doppler test and when is it done

Answer 15

all women get this at 20 weeks scan
identifies resistance in uterine arteries –> SGA
normally there should be no resistance in uterine arteries

Question 16

List consequences of IUGR

Answer 16

hypoxia 
death 
asphyxia 
hypothermia 
polycythaemia 
hyperbilirubinaemia 
still birth

Question 17

methods of assessing IUGR

Answer 17

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

Question 18

What should delivery timings be in SGA if all is well

Answer 18

37 weeks

Question 19

what are the indications for early c-section delivery

Answer 19

static growth
abnormal umbilical artery doppler
abnormal MCA doppler at 32-37 weeks

Question 20

What should be given to babies born before 36 weeks

Answer 20

steroids to promote foetal lung maturity

Question 21

When do you give magnesium sulphate and what is its benefit

Answer 21

born <32 weeks

provides neuroprotection against cerebral palsy

Question 22

uterine arteries should have low/high resistance in a normal pregnancy

Answer 22

low resistance

Question 23

difference between uterine and umbilical artery doppler

Answer 23

uterine - all women get this at 20 weeks

umbilical - used to assess foetal wellbeing in 3rd trimester, marker of placental insufficiency

Question 24

SGA is the same as IUGR, true or false

Answer 24

false

Question 25

umbilical arteries contain oxygenated/deoxygenated blood

Answer 25

deoxygenated

Question 26

umbilical veins carry oxygenated/deoxygenated blood

Answer 26

oxygenated