Small for dates pregnancy Flashcards
Define small for dates pregnancy.
Small for gestational age is a term used to describe babies who are smaller than number for the number of weeks of pregnancy. These babies have birth weight below the 10th percentile.
What is the aetiology of a small for dates pregnancy? What are risk factors for a small for dates pregnancy?
Low maternal BMI
Genetic factors
South Asian
First pregnancy
Preeclampsia
Placenta abnormalities
Infection during pregnancy
Genetic problems
Cocaine use
Smoking
Previous miscarriage
Summarise the epidemiology for small for dates pregnancy.
10% of babies
What are signs and symptoms of a small for dates pregnancy?
Small fundal height
Oligohydramnios
What is the management of a small for dates pregnancy?
Low dose aspirin for pre-eclampsia
Increased growth scans for baby
Umbilical Artery Doppler
CTG
Amniotic Fluid index
What would you expect to see in extreme prematurity < 28 weeks?
<1000g
Infants have decreased tone and extended rather than flexed extremity poster with a wide range of motion throughout.
They have little lanugo hair coverage over most of their bodies, no vernix caseosa, thin transparent/pink skin with visible veins, limited or no plantar creases, flat areolae with nearly imperceptible breast tissue, fused or open eyelids, folded ear pinna cartilage, preterm genitalia (male: scrotum empty with faint or no rugae,female: prominent clitoris and small or flat labia minora.
What would you expect to see in severe prematurity 29-31 weeks?
1000-1500g
Infants exhibit limited flexor posture with moderate range of motion throughout.
They are generally covered in lanugo with variable amount of vernix, have smooth pink skin with many visible veins, no plantar creases or faint markins, no areolar buds, open eyelids, folded or limited-recoil ear pinna cartilatge, preterm genitalia (male: testes in upper canal with minimal scrotal rugae, female: prominent clitoris with small/enlarging labia minora).
What would you expect to see in moderate prematurity 32-33 weeks?
1500-2000g
Infants have mild flexor tone and mild range of motion throughout.
They may have abundant or thinning lanugo with variable amount of vernix, few visible veins and some superficial skin peeling, faint red marks or an anterior transverse crease on plantar surface, rarely present areolar buds, open eyes, ears with some elastic recoil to pinna, preterm genitalia (male: testes palpable in canal or high in scrotum with rare to few rugae present; female: prominence of clitoris is waning and labia may be of equal size).
What would you expect to see in late-preterm 34-36 weeks?
2000-2750g
Moderate flexor tone in upper and lower extremities with limited range of motion.
They have superficial skin peeling to cracking with rare veins, thinning lanugo with bald areas, few creases on anterior plantar surface, small areolar buds, open eyes, ear pinna with ready elastic recoil, more mature genitalia (male: descended testes, with scrotal rugae present; female: equally prominent labia majora and minora).
What would you expect to see in a term baby 37-42 weeks.
Flexor posture and have limited range of motion.
They have variable degrees of skin cracking with no visible vessels, plantar creases cover the majority of the sole, full areolae with prominent buds, open eyes, formed pinna with immediate recoil, term genitalia (male: testes descended into the scrotum with prominent rugae; female: large labia majora and small labia minora).
