Small for Dates

Question 1

Small for Gestational Age Definition

Answer 1

Infant born with a birth weight of less than 10th centile, severe SGA if birth weight less than 3rd centile
Three Groups:
-Babies whose growth at all gestational ages has been low. SGA but otherwise healthy, foetal growth may be appropriate for maternal size and ethnicity
-Growth normal in early part of pregnancy but slows in utero by at least two measurements, this is due to IUGR, wasted appearance with little SC fat
-Non-placenta mediated-eg structural or chromosomal anomaly, inborn errors of metabolism or fetal infection

Question 2

Small for Gestational Age SGA vs IUGR

Answer 2

SGA is low size percentile, but IUGR is when growth slows, can be either without the other

Question 3

Small for Gestational Age RFs

Answer 3

• Maternal factors: low pre-pregnancy weight, under nutrition, substance abuse
• Medical conditions that affect placenta: pre-eclampsia, autoimmune disease, thrombophilias, renal disease, hypertension

Question 4

Small for Gestational Age RFs

Answer 4

• Minor: age ≥35, IVF singleton pregnancy, nulliparity, BMI>20, smoker, low fruit intake
• Major: Maternal age>40, smoker ≥cigarettes per day, FHx, cocaine use, daily vigorous exercise, PHx, diabetes, antiphospholipid

Question 5

Small for Gestational Age Diagnosis

Answer 5

Measure symphysis to fundal height serially, if concerning; USS
-Karyotyping if structural abnormalities

Question 6

Small for Gestational Age Management

Answer 6

• Antiplatelet agents may prevent SGA, should be used for women with high risk of pre-eclampsia
• If SGA diagnosed, single dose if corticosteroids